MANDATORY IN-PERSON REGISTRATION AT:
|
|
- Vernon Shawn Lucas
- 6 years ago
- Views:
Transcription
1 Registration Packet Limited annual memberships will be for sale to residents Thursday, Sept. 4, Non-resident registrations, pending availability, will be Wednesday, Oct. 1. MANDATORY IN-PERSON REGISTRATION AT: Community Recreation Center 505 N. Springinsguth Road Schaumburg, Illinois Tel: 847/ Fax: 847/ Remington Road, Schaumburg
2 Welcome Thank you for becoming a member of Schaumburg Park District s K-9 Park. Please read and complete the registration section of the following welcome packet. Registration: Resident registration begins Sept. 4, at the Community Recreation Center, 505 N. Springinsguth, Schaumburg. Non-resident registration begins Oct. 1, In-person registration is mandatory. Current vaccination records are mandatory for registration. All dogs must have current vaccinations for rabies, distemper, leptospirosis, parainfluenza, hepatitis and parvovirus. Registrations will not be processed without current vaccination records from your veterinarian. Registrations will not be reserved. No registrations will be processed by phone or online. Key Ring Tag Access: You will receive a key ring tag to access the park at the time of registration. Do not provide access to anyone who does not have a dog tag or registered dog. If your dog s vaccinations expire within the year, please forward updated records to the Park District via fax, mail or in-person. Failure to submit updated vaccination records will result in deactivation of your key ring tag within 30 days of vaccination expiration. Your key ring tag will be reactivated when membership is renewed. Please do not destroy or write on the dog tag. Key ring tags will be reused. Lost or damaged key ring tags may be replaced for $10 at the Community Recreation Center, 505 N. Springinsguth Road, Schaumburg, 847/ Key Ring Tag Problems: If your key ring tag does not work, please report it to the Schaumburg Park District at 847/ You must re-register annually with the Park District to ensure your key ring tag works. Be sure your dog s vaccination records are up-to-date. You cannot re-register your dogs without proof of current vaccinations.
3 Rules, Regulations and Etiquette Please be courteous to other dog owners. Please become familiar with the following Rules, Regulations and Etiquette on how to use the dog park. 1) You must purchase an annual permit membership at the Schaumburg Park District to use the Schaumburg K-9 Dog Park. Proof of current vaccinations are required. Memberships are available to residents and non-residents at the following rates: Annual Fee:... Resident: $60 park fee/$10 key ring tag fee/$10 per additional dog (limit of four dogs total, per owner) Non-resident (if available): $110 park fee/$10 key ring tag fee/$20 per additional dog (limit of four dogs total, per owner) Renewal:... $60 for residents and $110 for non-residents. No additional tag fee if key ring tag is undamaged. Replacement Key Ring Tags:... $10 2) K-9 Park Hours: 7 a.m. to 11 p.m. Dogs over 30 pounds must use the large area. Although not recommended, small dogs also may use the large dog area. 3) The agility area is open to large and small dogs. 4) Maximum two dogs per adult at the park. Both dogs must remain in the same run area with their owner. Large dogs (30 pounds and up) are not allowed in the small run area. 5) Dogs must remain leashed until they are inside the small or large run areas. For the safety of all dogs, no prong or pinch collars are allowed in the run areas. Leashes must be removed once in the park. If you are uncomfortable with your dog off the leash, please reconsider your visit to the park. 6) Owners must supervise their dog(s). Know where your dog is at all times and keep your leash at hand. 7) Dogs that are unruly toward other dogs must be removed immediately. 8) If your dog injures another dog or owner, give your name and phone number to the injured party. You are legally and financially responsible for your dog s actions and any harm caused to others or damage to property. See Dog Incident Policy attached. 9) Pick up your dog s droppings and any orphaned droppings. Carry extra bags with you. Bags and waste receptacles are available.
4 Rules and Regulations Continued 10) A handler must be age 18 or older and present at all times. The handler is solely responsible for the actions of their dog(s). Children between the ages of 11 and 17 are not permitted within the dog park unless accompanied by an adult. Children under 11 are not allowed in the park. 11) Dogs must display a current rabies tag and K-9 Dog Park colored dog tag. 12) Dogs in heat are not allowed in the park. 13) Dogs who are unhealthy are not allowed in the park. Flea and tick treatment is recommended, particularly during spring, summer and fall. 14) Dogs which exhibit exploratory mating behaviors or aggression (including urinating on other animals or people) should be removed immediately from the park to avoid injury to other dogs and owners. Chronic or habitual offenders will lose their K-9 Dog Park privileges. 15) Do not allow your dog to run to the gate when another dog enters. The gate area must be kept clear at all times so members can enter and exit without incident. For safety reasons, do not congregate near the entrance. 16) Puppies under six months old are not allowed in the park. 17) No smoking, glass containers, food including dog treats, rawhide, bones and hooves, alcohol or soft drinks are allowed in the dog park. This is to ensure the park stays clean and to prevent dogs from begging for food or showing aggressive behavior. 18) Water is available at the park. Please bring your own container. 19) No human sports of any kind are allowed in the park (rollerblading, football, baseball, bikes, skateboards, ice skating, etc.). 20) Do not allow people or dogs in the park who do not have a key ring tag or K-9 dog tag. Encourage visitors to call the Park District for more information about the K-9 dog park. Report fence jumpers to the police at 847/ or dial ) K-9 Park will be closed for maintenance 7-9 a.m. on Mondays and Thursdays. 22) Dogs may use the pond area. The pond is not for human swimming, fishing or ice skating. Access to the pond is through the gated area only. 23) Professional pet trainers may not use the park to conduct business. 24) If lightning detection system is activated, patrons must exit the park. 25) Failure to comply with the above rules may result in revocation of your park privileges.
5 Emergency Telephone Numbers Golf Rose Animal Hospital 1375 N. Roselle Road Schaumburg 847/ Website: Schaumburg Park District: Community Recreation Center 505 N. Springinsguth Road Schaumburg 847/ Village of Schaumburg Non-Emergency Police 847/ or dial 911
6 Dog Incident Policy Schaumburg Park District K-9 Park s Rules and Etiquette are designed to minimize the chance of dog incidents. Should an incident occur, the following actions are recommended: Separate and leash the dogs. Remove dogs to neutral area by main gate. Inspect dogs for injury. Exchange contact information between owners. Get names and phone numbers of any witnesses. If required, contact Animal Control, 847/ or dial 311. Cook County Animal Control requires all bites and scratches, either dog to dog or dog to human, to be reported within 24 hours. If an incident occurs, please call 911 so an officer can file the appropriate report. You are legally and financially responsible for the actions of your dog. See attached Waiver Form.
7 Dog Park Waiver and Release When this Waiver & Release refers to your dog, my dog, or the owner of a dog, it includes you whether or not you are the legal owner of the dog since you are the person responsible for the dog while using Schaumburg K-9 Park. Warning of Risk Dog activities are intended to provide a fun and rewarding experience for a dog and its owner/ handler. However, despite careful and proper preparation, instruction, medical advice, conditioning and equipment, there is still a risk of serious injury, including death to the dog, its owner/handler or other persons or animals. Dogs are pack animals and when off lead, even the best-trained dogs will act instinctively. Understandably, not all hazards and dangers associated with dog activities can be foreseen. Certain inherent risks include the propensity of any dog to behave in dangerous ways that may result in injury to you, another person or dog. Other risks include, but are not limited to, the inexperience, negligence or irresponsibility of a dog owner/handler; the inability to predict a dog s reaction to sound, movements, objects, persons, or other animals; and actions by the dog due to fright, anger, stress, insect bites or natural reactions such as jumping, pulling, resisting and biting. Other risks include the hazards associated with environmental and traffic conditions, acts of God, inclement weather, slips and falls, premises defects, equipment failure, failure in instruction/ supervision, and all other circumstances inherent to dog and/or outside activities. Should you attempt to break up a dog fight or restrain a dog, including but not limited to your dog, you may be attacked and severely mauled by your dog, the other dog or attacked by another dog s owner/ handler. In this regard, it must be recognized that it is impossible for Schaumburg Park District to guarantee absolute safety. Waiver and Release of All Claims and Indemnification Agreement Please read this form carefully and be aware that in consideration for permission to use Schaumburg K-9 Park, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which you or your dog might sustain as a result of participating in any and all activities connected with and associated with use of Schaumburg K-9 Park and surrounding area. (continued on back)
8 Waiver and Release Continued I recognize and acknowledge that use of Schaumburg K-9 Park and the surrounding area for dog activities and participating in dog activities entails certain risks of damage, loss or injury to animals, persons or property (including to me, other persons, my dog and other dogs or animals), and I voluntarily agree to assume the full risk and responsibility for any injuries, damages, loss, liability, costs and expenses, regardless of severity, extent or amount that (a) I, my dog or any other person accompanying me might sustain or incur as a result of my presence in this facility and surrounding area or my participating in any and all activities connected with or associated with use of Schaumburg K-9 Park and surrounding area; or (b) any other person or animal might sustain as a result of my or my dog s actions or conduct in connection with or associated with use of this facility and surrounding area. I do hereby agree to waive, relinquish, release and forever discharge (a) the Schaumburg Park District, and its officers, directors, employees and agents, and (b) any volunteer assisting or working on behalf of the Schaumburg Park District or any of its officers, directors, employees or agents (hereinafter collectively the Parties ) from any and all claims or causes of action for injuries, damages, loss, liability or expenses that I may have or which may accrue hereafter to me or any other person claiming through me or on my behalf and arising out of, connected with, or in any way associated with the use of Schaumburg K-9 Park and surrounding area. I further agree to indemnify and hold harmless and defend (a) the Schaumburg Park District and its officers, directors, employees and agents, and (b) any volunteer assisting or working on behalf of the Schaumburg Park District or any of its officers, directors, employees or agents (including but not limited to court costs and attorney fees), occurring, growing out of, incident to, or resulting directly to indirectly from my use of this facility and surround area, including without limitation any losses, claims, damages, liabilities, cause of actions and expenses on account of personal injury to or death of any person or animal, or damages to property of any person or entity (including but not limited to the Schaumburg Park District). I HAVE READ AND FULLY UNDERSTAND THE ABOVE IMPORTANT INFORMATION, WARNING OF RISK, ASSUMPTION OF RISK AND WAIVER AND RELEASE OF ALL CLAIMS. Permit Holder s Name (Please Print) Permit Holder s Signature Date
9 Key Ring Tag Serial #: Registration Walk-in registration only at Community Recreation Center 505 N. Springinsguth Road, Schaumburg Resident Fee:... $60 first dog; $10 per add l dog (Max 4 dogs) Non-resident Fee:... $110 first dog; $20 per add l dog (Max 4 dogs) Key Ring Tag Fee:... $10 Replacement Fee: $10 Name: Address: City: Zip: Home Phone: Secondary Phone: (Your address will help us communicate updates to dog park users. We will never share your with anyone else.) COMPLETE THIS SECTION. INCLUDE EACH DOG (max. 4 dogs per family). Attach a copy of vaccination records for each dog being registered. Schaumburg Park District requires the following vaccinations: Rabies, Distemper, Hepatitis, Leptospirosis, Parainfluenza and Parvovirus. These are all very standard vaccinations your dog should have. We strongly recommend Bordatella to help prevent the potential spread of Kennel Cough in Schaumburg. (1) Dog s Name: Color: Age: Breed: o Female o Male o Spayed o Neutered Dog Tag# FOR REFERENCE ONLY (2) Dog s Name: Color: Age: Breed: o Female o Male o Spayed o Neutered Dog Tag# (3) Dog s Name: Color: Age: Breed: o Female o Male o Spayed o Neutered Dog Tag# Must Register in-person at Community Recreation Center (4) Dog s Name: Color: Age: Breed: o Female o Male o Spayed o Neutered Dog Tag# o I have read and understand the Schaumburg Park District K-9 Dog Park rules. o I agree to provide updated immunization records if and when my dog s vaccinations expire in the current year. I understand that if I don t provide updated records, my key ring tag will be deactivated and will not be re-activated until I submit updated records. Print Name Signature Date IMMUNIZATION Rabies Distemper Hepatitis OFFICE USE ONLY EXPIRATION DATE IMMUNIZATION DOG 1 DOG 2 DOG 3 DOG 4 Leptospirosis Parainfluenza Parvovirus EXPIRATION DATE DOG 1 DOG 2 DOG 3 DOG 4 Total Paid: $ Check #: o Cash o Charge Accepted by: Date: White: SPD Copy Yellow: Member Copy Pink: Technology Copy
MUST REGISTER IN PERSON AT:
Registration Packet MUST REGISTER IN PERSON AT: Community Recreation Center 505 N. Springinsguth Road Schaumburg, Illinois 60194 Tel: 847/490-7020 Fax: 847/490-2498 120 Remington Road, Schaumburg ParkFun.com
More informationBourbonnais Township Park District. Dog Park Registration Packet
Bourbonnais Township Park District Dog Park 2018 Registration Packet Willowhaven Park & Nature Center 1451 N 4000E Rd Kankakee IL 60901 Tel: 815-933-9905 option 4 Fax: 815-933-5468 btpd.org BTPD Dog Park
More informationCity of McHenry McBark Dog Park. SPONSORED BY GARY LANG SUBARU 2500 N. Richmond Road McHenry, IL 60050
City of McHenry McBark Dog Park SPONSORED BY GARY LANG SUBARU 2500 N. Richmond Road McHenry, IL 60050 GENERAL INFORMATION The dog park facility is open to residents and non-residents who purchase an annual
More information2018 Registration Packet (membership expires April 15, 2019)
2018 Registration Packet (membership expires April 15, 2019) Frankfort Bark Park (80 th & Laraway, northwest corner of Commissioners Park) Voted one of America s Top Ten 2008 Dog Parks by Dog Fancy Magazine
More informationAugust 1, RE: McBark Park Dog Park Renewal
City of McHenry Parks & Recreation Department 3636 Municipal Drive McHenry, Illinois 60050 Phone: (815) 363-2160 Fax: (815) 363-3186 recinfo@ci.mchenry.il.us www.ci.mchenry.il.us August 1, 2018 RE: McBark
More informationPaws Town Boardman Park 375 Boardman-Poland Rd., Boardman, OH
Page 2 of 9 Welcome to Marge Hartman s Paws Town Dog Park! Thank you so much for considering a membership at Paws Town Dog Park in Boardman Park. Paws Town was built by a non-profit organization, Friends
More informationDOG PARK REGISTRATION
Ann Arbor Parks & Recreation Washtenaw County Parks & Recreation Commission DOG PARK REGISTRATION Dog owner information: Name Address City Zip Home phone Work/Cell phone Check box: City of Ann Arbor resident
More informationCity of Napoleon Dog Park Membership Application
Membership Application Owner Information First (s) Last (s) Mailing Address City State Zip Cell Phone Alternate Phone Email Address Emergency Contact Dog #1 Emergency Contact Phone Dog Information Color
More information1458 NORTH HARRIS ST. (S. CRAWFORD RD.) MT. PLEASANT, MI 48858
A partnership project between the City of Mt. Pleasant, Charter Township of Union, and Friends of the Dog Park 1458 NORTH HARRIS ST. (S. CRAWFORD RD.) MT. PLEASANT, MI 48858 Membership Packet and Policies
More informationMember Application. Date: Member s Name. Address. City / State / Zip. Phone . Emergency Contact Name: Relation: Emergency Contact Phone:
Member Application Date: Member s Name Address City / State / Zip Phone Email Emergency Contact Name: Relation: Emergency Contact Phone: Membership Plan: Spa Fido Fitness Squash Full Facility All memberships
More informationMember Benefits: One Year Membership: $40.00 Dog Wild Access Pass for unlimited access to the dog park during general-use hours.
Dog Wild Club Membership The primary benefit of becoming a member of the Dog Wild Club is access to the private, members-only Dog Wild Park. Memberships are valid for one year (12 months) and must be paid
More informationTOP DOG DAYCARE ADMISSION PACKET. Client Name Home Mobile Work. Client Name Home Mobile Work. Address.
Start Date TOP DOG DAYCARE ADMISSION PACKET Client Name Home Mobile Work Client Name Home Mobile Work Address E-Mail Emergency Contact (Not listed above) Home Mobile Work Vet Clinic Dog s Name Breed Birthday
More informationWADE S WIENERS BREEDING & BOARDING KENNELS BOARDING AGREEMENT
WADE S WIENERS BREEDING & BOARDING KENNELS BOARDING AGREEMENT OWNER S INFORMATION: Owner s Names: Address/City/State/Zip: Email Address: Phone: (Home) (Cell) _ Employment: (Phone) DOG S INFORMATION: Name:
More informationAPPLICATION. Cell phone.
333 North Bedford Road Mt. Kisco, NY 10549 Phone: 914-218-8258 Fax: 914-218-8259 Website: ckatthepark.com APPLICATION Owner Information Name Address Date Home phone Work phone Cell phone Email Services
More informationRequirements and Reservations
Requirements and Reservations Fuzzy Paws Pet Villa & Spa strives to provide a safe and positive experience for your dog(s). We have more than 20 years of pet care experience, and we pride ourselves in
More informationPhone: Fax: Page 1
Client Information Owner Name Address City State ZIP Home Phone Work Cell E-mail Address Occupation Employer Emergency Contact Name Home Phone Work Cell Pickup Authorization Name(s) Veterinary Information
More informationClient Enrollment Form Completed, signed and sent to us prior to first day of class.
Thank you for your interest in Wag Club! We can t wait to meet your pup! Below is a checklist of pre-requisites to help you complete enrollment for Training Classes, the Wine N Puppies playgroup and Special
More informationSHARP Siberian Husky Assistance & Rescue Program Adoption Contract
SHARP Siberian Husky Assistance & Rescue Program Adoption Contract The adopters stated below: Adopter 1: Adopter 2: Address: Phone number(s): Email address: Proof of residency provided: Do hereby acknowledge
More informationColumbus All-Breed Training Club, Inc.
Columbus All-Breed Training Club, Inc. Columbus, Ohio Dear Fellow Dog Lover, Thank you for your recent inquiry about our training classes. We are very proud of our training club and hope you will decide
More informationClient Information. Doggie Information
Client Information Client (Person) Name: Emergency contact(s) & numbers: Street Address: City, State, Zip: Phone1: Phone2: Phone3: Email: Alternate contacts: Who is authorized to pick up/drop off your
More informationGeneral Information. Whether it s for fun or competition there s a class to fit your schedule.
General Information If training your dog to leap over hurdles, crawl through tunnels, traverse a see-saw, scale an A-Frame, walk a plank suspended four feet above the ground, and weave though a line of
More informationApplication for Class Training Pre-registration is required. Space is limited!
PORTSMOUTH CHESAPEAKE OBEDIENCE TRAINING CLUB, INC Application for Class Training Pre-registration is required. Space is limited! I hereby apply for training in the Portsmouth-Chesapeake Obedience Training
More informationDaycare/Overnight Boarding Master Record Enables us to provide the most comfortable & safe experience for your pet.
Daycare/Overnight Boarding Master Record Enables us to provide the most comfortable & safe experience for your pet. Rules and Regulations Trial Day/Date Monday Thursday (must be in at 7:00am) Health: All
More informationPawington, LLC Boarding and Services Agreement
Pawington, LLC Boarding and Services Agreement Page 1 of 5 NOTICE TO THE PET OWNER/GUARDIAN: PLEASE READ CAREFULLY. THIS AGREEMENT INCLUDES A RELEASE OF LIABILITY AND WAIVER OF LEGAL RIGHTS AND DEPRIVES
More informationWARMINSTER TOWNSHIP BARK PARK PAW-PASS ACCESS INFORMATION & 2018 APPLICATION FORM
WARMINSTER TOWNSHIP BARK PARK PAW-PASS ACCESS INFORMATION & 2018 APPLICATION FORM Application Requirements: Paw-Pass Access: User Fees: Completion of the application form with copies of the required license
More information4-H Dog Project. Guidebook and Rules
4-H Dog Project Guidebook and Rules 2017 Welcome to the Taylor County 4-H Dog Project The purpose of this packet is to provide you with information about the Taylor County Dog Project. Once you and your
More informationClient Enrollment Form Completed, signed and sent to us prior to your first day of class.
Thank you for your interest in Wag Club! We can t wait to meet your pup! Below is a checklist of pre-requisites to help you complete enrollment for Training Classes, the Puppies N Wine playgroup and Special
More informationClient Information. Owner Name. Address. City State ZIP. Home Phone Work Cell
678-293-5933 www.puppytraining1on1.com @puppytraining1on1 Client Information Owner Name City State ZIP Home Phone Work Cell E-mail Occupation Employer Emergency Contact Name Home Phone Work Cell Pickup
More informationSweet Pea Kennels New Client Documents. Please to or fax to Name (First and last) Address
` Sweet Pea Kennels New Client Documents Please email to records@sweetpeakennels.com or fax to 573-534-0133 Name (First and last) Address City State Zip Home Number Cell Email Emergency contact Emergency
More informationBEGINNERS CLASS - FOR DOGS 5 MOS. AND OLDER. CLASSES ARE WEEKS FOR $. DO BRING YOUR DOGS TO THE FIRST NIGHT OF CLASS
If you wish to enroll in a training class you must fill out and return an enrollment form along with a $25.00 nonrefundable deposit. This will guarantee you a place in the class of your choice BEGINNERS
More informationPLEASE KEEP THIS PAGE FOR YOUR RECORDS
General Information about All Pets Dog Daycare DOGS ALL dogs must pass a temperament test prior to their first day of daycare. Temperament tests generally last 1 hour and an appointment is REQUIRED for
More informationSANDIA DOG OBEDIENCE CLUB
SANDIA DOG OBEDIENCE CLUB Thank you for choosing Sandia Dog Obedience Club. We have been in business for over 50 years, training dogs at all levels of AKC competition. Our main focus, however, is to help
More informationPAWSITIVELY PERFECT BOARDING & DAYCARE AGREEMENT. Address: City: State: Zip: Phone: Home: Work: Cell: Text? Y N
PAWSITIVELY PERFECT BOARDING & DAYCARE AGREEMENT Contact Information: Owner s Name(s): Address: City: State: Zip: Phone: Home: Work: Cell: Text? Y N Email: Do you check your email while gone? Y N Emergency
More informationDaycare & Boarding Application
New Daycare/Boarding Applicant Additional Family Member Existing Member s Updated Information Daycare & Boarding Application Guardian s/owner s Name: Address: City: State: Zip: Home Phone: ( ) Work Phone:
More informationCanine Enrollment Form
TODAY S DATE: *PLEASE PRINT CLEARLY IN INK* Full name and address (including zip) of owner / person/s responsible for payment: Driver s License Number: State license is issued in: Home Phone ( ) Work Phone
More informationAdoption Contract. I, (print name) (also referred to herein as Client ) residing at. Cell Phone #: Home Phone #:
Adoption Contract I, (print name) (also referred to herein as Client ) residing at (home address), am adopting the dog with the name (also referred to herein as dog ) from Beauty and the Bully. CLIENT
More informationPet Personality Profile
Pet Personality Profile Owner s Information Last Name: First Name: Phone: (cell) (home) (work) Email: Emergency Contact Name: Phone: Pet s Information Name: Breed: Color: Sex: M F Spayed/neutered? Yes
More informationPower Paws Assistance Dogs
Power Paws Assistance Dogs 1201 N. 85 th Pl. Ste. B101~ Scottsdale, AZ 85257 Phone 480-970-1322 ~ Fax 480-947-3090 www.azpowerpaws.org PUPPY RAISER APPLICATION Name Puppy Name Address Puppy s Date of Birth
More informationDAYCARE / BOARDING APPLICATION
Date: DAYCARE / BOARDING APPLICATION OWNER INFORMATION Address: City: Zip Code: Home phone: Cell: Work: E-mail Address: EMERGENCY CONTACT INFORMATION (someone t traveling with you) Relation: Home phone:
More informationTAUNTON HOUSING AUTHORITY PET POLICY
TAUNTON HOUSING AUTHORITY PET POLICY Residents of units owned and managed by the Taunton Housing Authority (the "Authority") may own and keep common household pets, provided, that they manage such pets
More informationONLY Current 4-H members are permitted to compete!!
20 Carbon County Fair Grounds 101 Rodeo Dr Red Lodge, MT (off of MT-78 N/3rd St) JUDGE: TBD ONLY Current 4-H members are permitted to compete!! CLASSES and RUNNING ORDER: This running order is subject
More informationRanger s Pet Outpost and Retreat Service Agreement
Ranger s Pet Outpost and Retreat Service Agreement 1239 Minnesota Avenue, Winter Park, Florida 32789 - (407) 622-4884 Fax (407) 622-5197 rangers@rangerspetoutpost.com Primary Contact Name Secondary Contact
More informationLost Coast Kennel Club of California
PREMIUM LIST AKC All-Breed Fast Coursing Ability Tests (Fast CAT) Lost Coast Kennel Club of California Friday July 5 th, 2019 AM Event # 2019215430 Friday July 5 th, 2019 PM Event # 2019215431 Saturday
More informationSAGUARO SCRAMBLERS AGILITY CLUB, INC. TUCSON, AZ
SAGUARO SCRAMBLERS AGILITY CLUB, INC. TUCSON, AZ Information for Non-Members at Arthur Pack Sunday Practices Saguaro Scramblers Agility Club is pleased to announce that non-members may now participate
More informationPaxton Dog Park Members Manual Guidelines, Rules, & Information
Paxton Dog Park Members Manual Guidelines, Rules, & Information Hours The Dog Park is open daily from dawn to dusk and it located off of Summer St. between Fall and Stockholm. For security and safety of
More informationTHE PURRING PARROT. Reservations, Deposit and Cancellation Policy
THE PURRING PARROT Client Information Owner s Name Date Address City State Zip Code Home Phone Cell Email Driver License Emergency Contact Phone Cell Phone Email Persons allowed to pick up and drop off
More informationRanger s Pet Outpost and Retreat Service Agreement
Ranger s Pet Outpost and Retreat Service Agreement 1239 Minnesota Avenue, Winter Park, Florida 32789 - (407) 622-4884 Fax (407) 622-5197 rangers@rangerspetoutpost.com Primary Contact Secondary Contact
More informationMEMORANDUM OF UNDERSTANDING BETWEEN
Animal Care Services GENERAL SERVICES DEPARTMENT 2127 Front Street Sacramento, CA 95818-1106 Tel: (916) 808-7387 Fax: (916) 808-5386 MEMORANDUM OF UNDERSTANDING BETWEEN CITY OF SACRAMENTO ANIMAL CARE SERVICES
More informationSend Rover on Over Application for Doggie Daycare and Sleepovers
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
More informationDog Park And Facility Rules With Release Of Liability
Dog Park And Facility Rules With Release Of Liability Entry into the dog park is at the risk of the dog owners or handlers. Dog owners or handlers are responsible for the behavior of their animals, and
More informationOwner s Name. Address. City State Zip Code. Home Phone Work Phone Cell Phone. Address Occupation. Employer. Emergency Contact s Name
712 Fairview Street Houston, Texas 77006 (713) 521-7877 fax: (713) 521-7879 www.daisysdoghouse.com CLIENT INFORMATION Owner s Name Address City State Zip Code Home Phone Work Phone Cell Phone Email Address
More informationAdoption Agreement. Spay/Neuter date: Sex: Tail: Ears: Adopter Name: Signature: Address: City, State, Zip:
Adoption Agreement Date: Dog Number:_ Dog Name: Birthdate/Age:_ Spay/Neuter date:_ Sex: _ Tail: Ears: _ Microchip #: Rabies Tag #: Adopter Name: Signature: _ Address: City, State, Zip: Phone: E-Mail: _
More informationHorry County Animal Care Center Public Spay Neuter Program
PROGRAM OUTLINE Horry County Animal Care Center Public Spay Neuter Program 1923 Industrial Park Road, Conway, SC 29526 Clinic: (843) 915 5171 Fax: (843) 915-6170 Email: shelter@horrycounty.org Hours of
More informationBOARD & TRAIN ENROLLMENT AGREEMENT
BOARD & TRAIN ENROLLMENT AGREEMENT Class Type: Starting Date: Dogs Information: Name: Age: Sex: Medications: Breed: Weight: Color: Spayed/Neutred: Past medical history: Current medical conditions: Allergies:
More informationOwner Liability Waiver and Health Certification
Owner Liability Waiver and Health Certification I,, hereby certify that my dog(s): is/are in good health and has/have not been ill with any communicable condition in the last 15 days. I further certify
More informationPLAY ALL DAY, LLC REGISTRATION FORM
Today s Date: How Did You Hear About Us? Owner(s) Name(s) Home Address City, State, Zip PLAY ALL DAY, LLC REGISTRATION FORM Start Date: OWNER INFORMATION Home Phone ( ) Work Phone ( ) Cell Phone ( ) Other
More informationAPPLICATION & ENROLLMENT
APPLICATION & ENROLLMENT OWNER S INFORMATION: Name: Address: City: State: Zip Code: Place of Employment: Home Phone: Work Phone: Cell Phone: E-mail Address: Emergency Contact Name (other than self): Relationship:
More informationAGREEMENT & WAIVER FORM
AGREEMENT & WAIVER FORM By signing this document I, as the owner/agent/guardian, guarantee that I will be personally liable for all expenses resulting from daycare, boarding, bathing and grooming, veterinarian
More informationBoarding/Daycare Contract
Boarding/Daycare Contract 1394 230th Street Glenwood City, Wisconsin 54013 715-265-9288 purrfectdog@live.com www.purrfectdog.com All boarding and daycare clients must sign a boarding/daycare contract for
More informationcleaning animal areas/feeding animals laundry washing dishes washing windows
STUDENT VOLUNTEER APPLICATION Welcome, and thank you for your interest in becoming a Woodbridge Animal Shelter Volunteer!! The student volunteer program is open to students 12-17 years of age. A parent
More informationPeace of Mind Pet Sitting s Doggy Day Care & Pet Services NEW CLIENT INFORMATION PET PARENT INFORMATION DOG S INFORMATION
Peace of Mind Pet Sitting s Doggy Day Care & Pet Services NEW CLIENT INFORMATION PET PARENT INFORMATION First Name Last Name Best Phone Number E-mail Date Your Dog s Veterinarian Clinic Preferred Doctor
More informationContract. You may print this document and fax or mail to: Nina M. Fetter Mowery Rd. Lima, Ohio 45801
Contract You may print this document and fax or mail to: Nina Fetter 5350 Mowery Rd. Lima, Ohio 45801 Cell (419) 230-7604 Office (419) 221-0046 - Fax (586) 601 2551 A G R E E M E N T This agreement is
More informationCLIENT ENROLLMENT FORM
CLIENT ENROLLMENT FORM We require this agreement, registration form, and up-to-date vet records before your dog board or train at Ruffgers. If you choose opt-out of vaccinations for your dog, a Titer Test
More informationDaycare Enrolment Form
Daycare Enrolment Form Office Use Only Enrolment Form Vaccination Record Signed Waiver Social Assessment Computer Entry First Day: How did you hear about WAG Canine? Contact Information Owner Information
More informationAustin K-9 Xpress Beginner Agility Class Registration Packet
Austin K-9 Xpress Beginner Agility Class Registration Packet Thank you for your interest in our Level 1: Beginner Agility class. This is your registration packet, which includes: registration form, two
More informationROVER lindblade street culver city, ca t f (Please Print Clearly) Owner s Name ::
(Please Print Clearly) Owner s Name :: Address :: City :: State :: Zip :: Home Phone :: Business Phone :: Cell Phone :: Email :: Name of Dog(s) :: 1. 2. Breed(s) :: 1. 2. Weight :: 1. 2. Color :: 1. 2.
More informationVancouver Island Performance & Earthdog Group presents
Vancouver Island Performance & Earthdog Group presents March 13, 2016 1:30 to 8 pm Open to all breeds and mixed breeds. Instinct, Novice and Open Fun Runs This event will be held according to the rules
More informationDaycare / Boarding Application
Daycare / Boarding Application Owner Information Name: Address: City: Zip: Home Phone: Cell: Email: Pet Information Name: Breed: Current Age: Weight: Birthday: Sex (check box): Male Female Spayed/Neutered?
More informationS.A.D. (Save All Doggies) All Breed Rescue Contract for Adoption of Rescue Dog
S.A.D. (Save All Doggies) All Breed Rescue Contract for Adoption of Rescue Dog IN CONSIDERATION of the payment of, the receipt of which is hereby acknowledged as full payment, the undersigned Adopter(s)
More informationDurham Kennel Club. Disruptive Dog Policy
Durham Kennel Club Disruptive Dog Policy Instructor Rights and Responsibilities (as they pertain to disruptive dogs) 1. Instructors have the responsibility to see that all handlers and dogs enrolled in
More informationCUTEODYSSEY Small Dog Rescue San Diego, California ADOPTION CONTRACT
Cuteodyssey Maternal Shih Tzu Rescue and Small Breed Rescue Adoption Contract. Page 1 CUTEODYSSEY Small Dog Rescue San Diego, California ADOPTION CONTRACT Cuteodyssey Maternal Shih Tzu and small breed
More informationPaw Paw s Pets 3124 Broad Avenue Memphis, TN
Paw Paw s Pets 3124 Broad Avenue Memphis, TN 38112 901-286-5488 New Member Application Parent / Pet Owner Information Name(s): Address: City: State: Zip: Home Phone: Cell: Email: How did you hear about
More informationDaycare Application Form
Daycare Application Form To help ensure the health and safety of your dog and those already in our care, Please provide as much detailed information as possible throughout the application form. Owner details
More informationRESCUE DOG VILLAGE, LLC Foster Contract
Foster Contract FOSTER NAME ADDRESS CITY STATE ZIP PHONE EMAIL Agree to, voluntarily and upon my consent, temporarily care for homeless dogs on behalf of Rescue Dog Village, LLC. While in my care, I will
More informationGOLDEN RETRIEVER RESCUE OF HOUSTON, INC. (GRRH) P.O. Box Houston, Texas Phone: goldens&grrh.org Website:
GOLDEN RETRIEVER RESCUE OF HOUSTON, INC. (GRRH) P.O. Box 19594 Houston, Texas 77224 Phone: 713 521 9019 Email: goldens&grrh.org Website: www.grrh.org This agreement is made this day of in the year of,
More informationMEMBERSHIP APPLICATION
NoDa Bark and Board MEMBERSHIP APPLICATION Today s date: OWNER INFORMATION: (Please print) Name: Address: City: _ State: Zip: Home Phone: _ Cell: _ Employer: _ Work Phone: E-mail Address: EMERGENCY CONTACT:
More informationGerman Pinscher Club of America Rescue. (GPCA Rescue)
German Pinscher Club of America Rescue (GPCA Rescue) A d o p t i o n A g r e e m e n t & R e l e a s e S t a t e m e n t Our adoption agreement is designed with one purpose to protect the companion animal
More informationINDIVIDUAL RESCUER ADOPTION APPLICATION/CONTRACT INFORMATION
INDIVIDUAL RESCUER ADOPTION APPLICATION/CONTRACT INFORMATION Rescuer s Name: My goal is to place (insert pet s name) in a permanent, loving home. I RESERVE THE RIGHT TO DECLINE ANY APPLICATION. The adoption
More informationThe Pet Resort at Greensprings, Inc.
The Pet Resort at Greensprings, Inc. 2878 Monticello Avenue Office: 757-220-2880 Williamsburg, VA 23188 Fax: 757-220-0094 caring@williamsburgpetresort.com Boarding, Day Camp, Grooming & Training Agreement
More informationPaws & Claws. Pet Boarding. At Hector s Hay and Feed. 589 South Main St. Snowflake, AZ BOARDING AGREEMENT
Paws & Claws Pet Boarding At Hector s Hay and Feed 589 South Main St. Snowflake, AZ 85937 928-536-9963 BOARDING AGREEMENT Please read this agreement in its entirety before signing Pet s Name Sex M / F
More informationSequoyah German Shepherds (423)
Sequoyah German Shepherds (423) 991-0979 Whereas SEQUOYAH SHEPHERDS, hereafter called Seller is the breeder of a German Shepherd Puppy, further described as: 1. Description of Dog Call Name: AKC Litter
More informationDOG PARK REGISTRATION FORM
E. Lorraine Gott OFF-LEASH DOG PARK 750 Jamaica Blvd. Satellite Beach, Florida DOG PARK REGISTRATION FORM All participants using the off-leash dog park are required to submit the proper registration forms
More informationDemi s Animal Rescue Foster Agreement (Dog)
Demi s Animal Rescue Foster Agreement (Dog) Date Animal s Name: Breed: Sex: Weight: Age: Microchip ID: Notes: The parties agree that the foster shall abide by the following conditions: 1. (Name) hereinafter
More informationRegistration Form for Training Classes:
Registration Form for Training Classes: Please sign and complete the form below. Registration form and proof of vaccines* are required by the start of the first class. They can be scanned and emailed or
More informationDaycare & Sleepover Registration Form
Dog s Name Dog s Birthday Daycare & Sleepover Registration Form Owner(s) Information Name(s): Address: City: Postal Code: Home Phone: Cell: Business: Email: Emergency Contact Name: Address: Email: Home
More informationAge: All dogs must be at least 16 weeks or older. Puppies and shelter dogs must have been at home for 2 weeks prior to coming to daycare.
Dogs @ Play Daycare Requirements To ensure the health and safety of your pet and of our other guests, we require that all of our clients comply with the following rules and regulations. Age: All dogs must
More informationBoarding Consent/Registration Form
Boarding Consent/Registration Form Café Free Boarding (Daycare dogs onl Traditional Boarding Thank you for choosing Rex s Place and Rex s Place Boarding House to care for your pet(s) while you re away.
More informationC o m p l e t e C a n i n e C a r e E n r o l m e n t F o r m P a g e 1 5. OWNER INFORMATION Forename & Surname. Home Phone Work Phone Mobile Phone
OWNER INFORMATION Title Forename & Surname Home address Work address Home Phone Work Phone Mobile Phone Email PARTNER/SPOUSE Name Work Phone Mobile Phone How did you hear about us? Word of mouth Email
More informationDemi s Animal Rescue, Inc. Terms of Adoption (Dog) Animal s Name: Breed: Sex: Weight: Age: Microchip ID: Notes:
Date Demi s Animal Rescue, Inc. Terms of Adoption (Dog) Animal s Name: Breed: Sex: Weight: Age: Microchip ID: Notes: In consideration for Demi s Animal Rescue, Inc. ( the Rescue ) agreeing to transfer
More informationBarn Hunt Fun Test September 3, :00 a.m.
Permission has been granted by the Barn Hunt Association, LLC to hold of this barn hunt fun test under BHA Rules and Regulations. For a copy of the rules go to www.barnhunt.com. Barn Hunt Fun Test September
More information2015 Highland County 4-H Dog Project Registration. 4-H er s Name Age (1/1/14) Address P. O. Box or Street City Zip
2015 Highland County 4-H Dog Project Registration This form can be used as a Dog Project Registration tool. 4-H er s Name Age (1/1/14) Address Phone No. P. O. Box or Street City Zip Email 4-H Club Dog
More informationSERVICE CONTRACT. THIS AGREEMENT is entered into by and between WAGS & WIGGLES DOG DAYCARE, PART DEUX, LLC (the Wags & Wiggles ) and ( Owner ):
SERVICE CONTRACT THIS AGREEMENT is entered into by and between WAGS & WIGGLES DOG DAYCARE, PART DEUX, LLC (the Wags & Wiggles ) and ( Owner ): 1. Owner understands and agrees that Owner is solely responsible
More informationGREAT DANE RESCUE ALLIANCE, INC. Volunteer Application
GREAT DANE RESCUE ALLIANCE, INC. Volunteer Application Please Return to: Brittany Dail 3759 Countryaire Drive Ayden, NC 28513 Today's Date 1. Name 2. Email Address 3. Address 4. Phone # Cell Phone # Fax
More informationLucky Dog Events! Barn Hunt Fun Test!
Lucky Dog Events Barn Hunt Fun Test Saturday, August 30, 2014 Gemini Dogs (indoors) 53-B Ayer Road, Littleton, MA 01460 Classes Offered: Instinct, Novice, Open - (2 rounds each) Start time 9:00 AM Judge:
More informationDecember Evening Barn Hunt Trial
October 6, 2016 December Evening Barn Hunt Trial Hosted by: Classes Offered Instinct through Master Dog Sports America Entries Open October 12, 2016 Sanctioned by: Entries Close November 27, 2016 Barn
More informationCITY OF MORENO VALLEY COMMUNITY DEVELOPMENT DEPARTMENT ANIMAL SERVICES DIVISION RESCUE / ADOPTION PARTNER ORGANIZATION AGREEMENT
CITY OF MORENO VALLEY COMMUNITY DEVELOPMENT DEPARTMENT ANIMAL SERVICES DIVISION RESCUE / ADOPTION PARTNER ORGANIZATION AGREEMENT The City of Moreno Valley (City) is committed to working with RESCUE / ADOPTION
More informationFRANCISCAN VILLAGE ANIMAL OWNERSHIP RULES
FRANCISCAN VILLAGE ANIMAL OWNERSHIP RULES (Including Pets and Assistance Animal s) Summary: "The TENANT is permitted to keep common household pets in his/her dwelling unit (subject to the provisions in
More informationPanther Ridge Wild Feline Conservation Academy. Frequently Asked Questions
Panther Ridge Wild Feline Conservation Academy The Panther Ridge Wild Feline Conservation Academy is an intense feline centered education program for high school students who are interested in zoological
More informationPET POLICY HOUSING AUTHORITY OF THE CITY OF CHEYENNE
PET POLICY HOUSING AUTHORITY OF THE CITY OF CHEYENNE EXCLUSIONS Assistance or Companion animals that are needed as a reasonable accommodation for persons with disabilities are not considered pets, and
More informationDOG OBEDIENCE CLASSES Offered in Partnership with Sparta Area School District Community Education
Offered in Partnership with Sparta Area School District Community Education Classes begin Wednesday March 6, 2019 and will continue every Wednesday night for 8 weeks (Puppy Preschool is a 6 week class*).
More information