Willow Dog Walking HOME BOARDING BOOKING FORM PERSONAL DETAILS: Title: Mr, Mrs, Ms etc: First Name: Surname: Address: Postcode:

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1 HOME BOARDING BOOKING FORM PLEASE NOTE: If your dog is lively and difficult to manage, this it is not suitable for the service we provide and would be best placed in a kennel. However, if your dog has a calm and placid temperament, please continue to complete this form. PERSONAL DETAILS: Title: Mr, Mrs, Ms etc: First Name: Surname: Address: Postcode: Contact details: Telephone Numbers (Home): (Work): (Mobile): address: DATES OF TRIP AND APPROXIMATE ARRIVAL AND COLLECTION TIMES: Arrival Date: Approximate Time: Collection Date: Approximate Time: ABOUT YOUR DOG Dog s Name: Dog/Bitch: Size: Small/Medium/Large Age: Spayed/Castrated Breed and Description of Dog: FEEDING: Food is provided by yourself, can you tell us his or her existing feeding pattern: HEALTH: (Please give details of poor health and medication) Address of your Vet: Date of last Vaccination: PLEASE PRODUCE YOUR PETS VACCINATION CARD ON EACH VISIT

2 ABOUT YOUR DOG / Cont d Describe your dog s level of obedience, and any unusual command words that you dog respond to: Where does your dog usually sleep? Hall, Lounge etc. Could your dog be place in a family with older children? Could your dog be placed with another dog? (This would only occur on changeover days) Does your dog pull on a lead when out for walks? Yes/No IS YOUR DOG LIKELY TO (Please circle the appropriate answer) JUMP ONTO FURNITURE? OFTEN OCCASIONALLY NEVER JUMP UP AT PEOPLE? OFTEN OCCASIONALLY NEVER BARK? OFTEN OCCASIONALLY NEVER WHINE? OFTEN OCCASIONALLY NEVER CHEW FURNITURE? OFTEN OCCASIONALLY NEVER FIGHT WITH OTHER DOGS? OFTEN OCCASIONALLY NEVER SCRATCH CARPETS OR DOORS? OFTEN OCCASIONALLY NEVER DOES YOUR DOG MESS OR URINATE IN THE HOME? Yes/No If yes, please give details of frequency etc DOES YOUR DOG CHEW OTHER THINGS? (e.g. Pens, Paper, Small objects) IS YOUR DOG POSSESSIVE OR PROTECTIVE OVER FOOD, TOYS, CHEWS, COLLAR etc? PLEASE GIVE DETAILS OF ANY OTHER RELEVANT INFORMATION THAT WOULD BE USEFUL TO YOUR DOG CARER:

3 TERMS AND CONDITIONS 1. If you insist that your dog be let off the lead, the carer requires that you accept full responsibility if your dog runs away or gets lost. 2. CANCELLATION CHARGES apply. My dog is non-aggressive, but should it show aggressive tendencies towards the dog carer or their family, or should it s behaviour become uncontrollable or a nuisance beyond reasonable acceptance, I agree that he/she will be placed in a Dog Boarding Kennel until my return and that this will be subject to a 10 transfer charge. I also agree for the carer to make any decisions regarding my dog s health providing it is acting in the best interest of my dog and is on the advice of a qualified veterinary surgeon. If I would prefer, I can write down a contact number at the bottom of the page of someone who could make these decisions if an emergency situation should arise. Vet bills that my dog may incur will be met by me on my return. I agree that if I do not turn up on the agreed date to board my dog I will be liable for the full payment. I agree to the conditions for cancellation as stated and to pay the deposits of cancelled bookings as stated. Signed: Date: THANK YOU FOR COMPLETING THIS FORM, PLEASE RETURN IT TO THE ABOVE ADDRESS WITH THE DEPOSIT EMERGENCY CONTACT NAME: TELEPHONE NO: (if different from information supplied)

4 WILLOW DOG WALKING HOME BOARDING TERMS & CONDITIONS FLEXIBLE FAMILY FRIENDLY PET CARE. 1. You will present the dog for boarding in a clean and groomed condition and with up to date vaccinations, de-flea and anti-worming treatments. 2. You will need to supply the necessary dog food and treats for the duration of the stay. If additional food or treats are required you agree, upon presentation of a receipt, to refund Small Dog Boarding. 3. You agree that if you instruct Small Dog Boarding to exercise your dog off the lead you accept full liability for any loss or damage caused as a result of your dog being off the lead. In the event that your dog attacks a person or a dog or in the event that he/she is involved in a fight with another dog/person causing any damage or injury you agree to be responsible for any losses incurred including payment of veterinary fees or any medical treatment required. 4. We are unable to accept bookings for a dog subject to the terms of the Dangerous Dogs Act 1991 or any other dogs with aggression problems towards other dogs and/or people. 5. Reasonable efforts will be made to contact you in the event of an emergency. However, Small Dog Boarding reserves the right to make decisions regarding your dog s health provided it is at all times acting in the best interests of the dog and on the advice of a veterinary surgeon. If your dog becomes unwell, has an accident or injures himself/herself or seems to be in any type of pain, we might need to take him/her to a veterinary surgeon and you agree to be responsible for payment of all the veterinarian fees incurred. 6. You undertake to make full disclosure of any quality or characteristic which might make your dog not suitable for home boarding, including, but not limited to behavioural or health problems, anti-social behaviour including aggression, incontinence/lack of housetraining or excessive loud barking/whining. Failure on your part to disclose any matter which might render the dog unsuitable for home boarding will be deemed a material omission amounting to a fundamental breach of this agreement. You will also be liable for additional costs if Small Dog Boarding experiences difficulties due to failure to disclose in the booking form any matter that would be accepted as reasonably unsuitable for home boarding. 7. All deposits are due at the time of booking. Your booking can only be confirmed when both the deposit and the signed booking form have been received. Small Dog Boarding is not able to keep bookings open for more than 10 days so bookings will be released. 8. Your deposit is not refundable if you cancel within 10 days of your booking. 9. If our Small Dog Boarding is unable to fulfil a booking, we will use all reasonable endeavours to arrange an introduction to another suitable boarding service. If we are not able to recommend an alternative boarding service, we will refund your booking deposit.

5 I confirm that I am the owner of the above mentioned dog. I have understood and agree to the above terms and conditions. I also confirm that the information supplied is correct and that any additional information that Small Dog Boarding should be aware of is also supplied and Small Dog Boarding will be made aware of any changes. Signature of owner..... Name Date....