Send Rover on Over Application for Doggie Daycare and Sleepovers

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1 Send Rover on Over Application for Doggie Daycare and Sleepovers Dog s Name Owner s First and Last Name Phone # (Work/Home) Cell # Breed Gender Color Birth Date Age Spayed/Neutered (All Daycare and Sleepover dogs must be spayed or neutered by seven months of age.) Does he/she have a microchip? Is he/she licensed? Please transfer your vaccines records to this area below: Date of last Rabies shot Date of last Bordatella Date of last DHLPP Is your dog on a flea & tick control program? Which type? Last dose? (All Daycare and Sleepover dogs must be on a flea and tick control program. Feel free to ask your veterinarian about options.) Social activity questions: Has he/she previously been in a social environment? Circle those that apply: Dog Park Agility Training Housemates Daycare Other Has he/she ever bit a human? Has he/she ever bit another dog? Does your dog interact well with other dogs? With puppies? With older dogs? With smaller dogs? With larger dogs? Is he/she housetrained? Is there anything else we should know about your dog? What s your reason for bringing your dog to Daycare? How did you hear about us? Has your dog had any formal training? Type of training and where? Page 1 of 5

2 Parent/Guardian Info Address City State Zip Code Emergency Contact name and # In case you are unable to pick up your dog from Daycare, who do you authorize to pick him/her up for you? Name(s) Number(s) Name and Number of Veterinary Clinic: Parent/Guardian Signature Date Credit/Debit card you would like us to keep on file. Please include the expiration date and three-digit code. Sorry, we do not currently take American Express. Card # Exp. Date Three digit code on the back Zip code SROO Staff area Date Initials Entered in CC PD for ASF/1 st Day Page 2 of 5

3 Training: Are you interested in any of our Training programs? (Please circle the ones you re interested in) We offer the following fun classes and programs: Puppy Play- A complimentary social environment where your pup 8-20 weeks gets to interact with other young pups. Puppy Kindergarten- Private lesson for puppies 8-20 weeks Puppy All Star- Group lessons for puppies, Jr. version of Canine Good Citizen Basic Manners- Learn sit, down, stay, walk nice on a leash, come, leave it and more Canine Good Citizen- Fine tune basic manners and prepare for the Canine Good Citizen Test Reactive Rover- For dogs who are a challenge to walk and/or may exhibit unpleasant behaviors in a public setting Private Lessons- On site or at your home for behavioral modifications Agility for fun- A popular and fun, non-competitive class. Preps your dog to become familiar to agility equipment. Scent Tracking- Teach your dog how to find your stuff using their natural abilities to scent Fly ball- Relay racing for ball loving dogs Dock Jumping- Seasonal sporting class where your dog learns to gain distance while jumping off a dock into the water Therapy Swim- Seasonal class for dogs who are obese or have arthritis pain Cage free boarding- We offer cage free boarding in a separate sleepover room. A slumber buddy stays throughout the night with your dog at our facility. Weekend Daycare- We are open Saturday and Sunday from 9am-5pm. Grooming- We offer basic baths and fancy haircuts. Please inquire within. Page 3 of 5

4 Release and Waiver of Liability and Assumption of Risk Send Rover on Over Inc. has created a dog center for dogs and their owners to enjoy. I understand that the use of the dog center means that I am taking risks of damage or injury to myself, guests, personal property, and my own dogs and to others in the facility. I realize that when dogs are around people, other dogs and distractions, some accident or injury may result, and that people, dogs and property might be injured or damaged. In exchange for the opportunity to use this dog center, according to the policies, I hereby release and discharge Send Rover on Over Inc., and its owners, members, employees, successors, assigns, and all affiliated parties from any and all liability, claims, demands, causes of action, loss, damage, or injury to people or property, including any death and/or serious injury which may result while I, my guests or my dogs are on the premises of Send Rover on Over Inc. or attending an event sponsored by Send Rover on Over Inc. I hereby certify that I am eighteen (18) years of age or older and have the legal capacity to enter into a binding contract under the laws of the state of California. I intend for this release to be binding upon my heirs, beneficiaries, next of kin, personal representative or executor and assignees. I have read, understand and agree to abide and be bound by the terms and conditions of Send Rover on Over Doggie Daycare and Training Center and its entirety. I understand that Send Rover on Over Inc. Management reserve the rights to alter or amend the dog facility rules at any time with or without prior notice. Owner/Guardian signature Printed name Dog s name and breed Date signed Page 4 of 5

5 Release of Liability and Agreement of Terms Although Send Rover on Over provides Daycare to people and dog friendly dogs, an occasional injury, accident or illness can occur. Please be aware that in an open play environment, all of the following can occur: bites, bumps, bruises, scrapes, scratches, hickeys, lacerations, diarrhea, ingested toy parts, collars being chewed and your dog may contract a virus or illness that they are not immunized against. Don t let this scare you. The benefits of allowing your dog to play, socialize, be cared for in a supervised environment should outweigh the above possibilities. Please initial each line below. In the event of a medical illness or injury, I am aware that I am responsible for my own dog s medical expenses. I will not bring my dog into the facility if they are sick, coughing, sneezing, have a contagious rash or diarrhea. Dogs must be carried in or on a leash at all times and on a regular, quick release collar. (Because we are a positive reinforcement facility, please no choke chains, prong collars or shock collars allowed). We are closed Monday-Friday between 12-2pm for formal naptime. During these times, we do not release dogs unless it s an emergency. Please pick up your dog at or before 11:30am for half day, and at or before 6:30pm for full day. We will feed and bed your dog in our overnight area at 6:30pm if your dog is left here, and overnight/late pick fees will apply. Please have your dog here by 9am for the morning sessions and at 2pm for the afternoon session. We require a 48 hour cancellation for any of our services. You will be charged a no show fee equal to a half day of daycare if we do not have sufficient time for your cancellation. You must provide a working phone number to us where you can be reached at during the day when your dog is at daycare or for boarding. No refunds will be issued for daycare purchases. Punch cards that have been inactive for four months or more will be purged and we will need a new method of payment if needed We recommend leaving your credit card on file for daycare, boarding, grooming and other purchases. Please bring your dog a treat during nap time (dog biscuits, a stuffed bone or stuffed Kong toy, wet food, rawhide bone, greenies, bully stick, chew bones, etc.) Please do not bring kibble as a nap time snack due to dogs having severe allergies to kibble that might end up spilling (Kibble is okay if your dog is under six months or has a medical condition as to why they need to eat three times a day) Your dog may get dirty while playing here and baths can be scheduled. In the event your dog bites a staff member, we will ask you to volunteer to pay for minor medical services that may be required. In the event that your dog bites a staff member, your dog may need to go on quarantine according to the Animal Regulation Dog bite Guidelines By signing below, you are releasing Send Rover on Over of any and all liabilities that may occur on these premises and agreeing to the terms stated above. Dog s name Dog s breed Name and Signature Date Page 5 of 5

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