The Barking Orange Daycare Application (Updated September 2015)
|
|
- Alaina Simpson
- 5 years ago
- Views:
Transcription
1 The Barking Orange Daycare Application (Updated September 2015) Contact & General Information Your Name Street Address City, State, ZIP Code Home Phone Cell Phone Work Phone Address How Did you Hear About Us? Your Dog s Name Male or Female Date of Birth Spayed / Neutered Breed Color Weight Vet s Name Vet s Phone Number Pet Personality Profile How long have you had your dog? Where did you get your dog? If you rescued your dog, do you have any information on your dog s history? Please indicate Yes or No to help describe your dog s personality Playful Shy Affectionate Outgoing Submissive Insecure
2 Gentle Mouthy Avid Barker Quiet Jumpy Excitable Describe your dog s activity level: Low Medium High Is your dog crate trained? YES NO If YES, does your dog like being in his/her crate? YES NO Please indicate Yes or No to help describe the situations where your dog may become unfriendly or react in a negative manner Grabbing collar Being removed from furniture Touching ears Touching tail Removing a toy from mouth Hugging Being touched while sleeping Touching paws Being pet OTHER (please indicate) Has your dog gone to daycare before? If yes, please describe. Has your dog ever bit another dog? If yes, please describe. Has your dog ever been bitten by another dog? If yes, please describe. Is your dog a resource guarder (Food aggressive, toy aggressive, protective of people?) If yes, please describe Is your dog sensitive to noise? Does your dog like children? Does your dog have any health issues? If yes, please describe. Does your dog have allergies? If yes, please describe reaction and allergy.
3 Does your dog have any dietary restrictions? Does your dog go to dog parks? If yes, has he or she ever exhibited aggressive behavior towards other dogs/people at the park such as mouthing, teething or raising hackles? What does your dog do when you are not at home? Are there any people your dog dislikes or fears? How does your dog react to small dogs or puppies? Has your dog ever growled or snapped at anyone who has tried to take food or toys away? Has your dog ever climbed a fence? Interests Tell us what your dog likes to do! Indicate with an X or check mark. Running Playing with balls Playing with toys Jumping Tricks Eating Sleeping OTHER
4 Special Instructions or Other Important Stuff we should know Daycare Schedule Let us know what days you are planning on bringing your dog to The Barking Orange. Mondays Tuesdays Wednesdays Thursdays Fridays Half Days Person to Notify in Case of Emergency (in case we can t reach you) Name Street Address City, State, ZIP Code Home Phone Cell Phone Work Phone Address Name Street Address City, State, ZIP Code Home Phone Cell Phone Work Phone Address
5 Agreement and Signature By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if my dog is accepted to The Barking Orange, any false statements, omissions, or other misrepresentations made by me on this application may result in an immediate dismissal. Name (printed) Signature Date The Barking Orange Rules & Policies All potential customers are required to complete an application and participate in a screening/interview prior to joining The Barking Orange. Current vaccination records must be provided to The Barking Orange by the first day of daycare. All dogs must continue to be up to date with shots on an annual basis and provide The Barking Orange with updated records. We do ask that you give your vet permission to release records to us so that we can easily obtain them going forward. All dogs must be spayed or neutered at 6 months in order to participate in daycare Payment is due on the day of service. Pre-paid services are also accepted. Packages expire 1 year after date of purchase. There are no refunds. Dogs admitted to The Barking Orange should attend daycare monthly and The Barking Orange reserves the right to re-interview dogs that have been out of daycare for more than a month. Sick dogs should remain home and out of daycare. The Barking Orange reserves the right to send home a dog we may feel is sick. Customers should communicate illnesses to The Barking Orange and we will do the same. Customers are required to keep their dog on a leash or in a crate upon entering and leaving The Barking Orange facilities and parking lots. Barking Orange customers will abide by all leash law and dog waste pick up protocols while in the neighborhood. Your dog may be removed from daycare for fighting, leaving a mark on a dog or staff member, being overly stressed out, not listening, and or if novelty has worn off. Please sign below indicating you have read and agreed to our rules and policies. Name (print) Signature Date
6 The Barking Orange Pet Care Agreement 1. I understand that The Barking Orange, LLC has relied upon my representation that my dog is in good health and has not injured or shown aggressive or threatening behavior to any person or dog in admitting my dog for services at The Barking Orange, LLC facility. 2. I further understand that The Barking Orange, LLC owners and staff will not be liable, financially or otherwise, for injuries to my dog, myself, or any property of mine while my dog is participating in services provided by The Barking Orange, LLC. I hereby release The Barking Orange, LLC of any and all liability of any kind arising from my dog s participation in any and all services provided by The Barking Orange, LLC. 3. I further understand and agree that any problems with my dog, including behavioral, medical or otherwise, will be treated as deemed appropriate by the staff of The Barking Orange, LLC at their sole discretion, and in what they view as the best interest of the dog. I understand that I assume full financial responsibility and all liability for any and all expenses involved in regards to the health and well-being of my dog. 4. I further understand that there are risks and benefits associated with group socialization of dogs. I agree that the benefits outweigh the risks and that I accept the risk. I understand that while the socialization and play is closely and carefully monitored by The Barking Orange, LLC staff to prevent injury, it is still possible that during the course of normal play my dog may receive minor abrasions from contact with other dogs. 5. I further understand by allowing my dog to participate in services offered by The Barking Orange, LLC, I hereby agree to allow The Barking Orange, LLC to take photographs, video or use images in print form or otherwise of my pet for publication and or promotion. 6. I further understand that I am solely responsible, financially or otherwise, for any harm or damage caused by my dog while my dog is attending any services provided by The Barking Orange, LLC. 7. I further understand that The Barking Orange, LLC reserves the right to refuse admittance of my dog at any time if problems shall arise from my dog s participation at The Barking Orange, LLC. 8. I further understand that if a medical emergency, as deemed by staff of The Barking Orange, LLC occurs involving my pet, I hereby authorize the staff to seek any and all medical attention necessary at the facility the staff deems appropriate. I also agree to be financially responsible for any and all medical treatment my pet receives as a result of this action. 9. I further understand that if my dog is not picked up on time or by a date specified in a separate agreement I hereby authorize The Barking Orange, LLC to take whatever action is deemed necessary for the continuing care of my dog. I will pay The Barking Orange, LLC the cost of any such continuing care of my dog. I understand that if I do not pick up my dog, The Barking Orange, LLC will proceed according to the guidelines provided by the New York State Article 26, Chapter 353 & 353-a, Cruelty to Animals; procedure for handling. I also acknowledge that I will be fully responsible for all attorneys fees and associated costs if I abandon my dog. Name (print) Signature Date
Bed & Biscuit, Inc. Doggie Daycare and Boarding. Name: Address: City: State: Zip Code: Home Phone #: Work #: Cell #
Doggie Daycare and Boarding FOR OFFICE USE ONLY Enrollment Form Shots Staff Screened Computer Entry Folder Made First Day EMERGENCY CONTACT INFORMATION Owner Information Name: Address: City: State: Zip
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 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 informationEnrollment Form, Pet Profile and Liability Release. Enrollment Form
Enrollment Form, Pet Profile and Liability Release A completed Enrollment Form and Pet Profile must be submitted for each pet attending Timberlane Pet Hospital & Resort before an interview is scheduled.
More informationDOG DAYCARE APPLICATION FORM
DOG DAYCARE APPLICATION FORM How Did you Hear About Us? Your Name: Address: Postal Code Home Phone ( ) - Work ( ) Cell: ( ) Email Address: If we can t get in touch with you who can we call? (Emergency
More informationDaycare Application Form
Daycare Application Form TGDS Staff Use Only Evaluation Date: Application Complete: Liability Waiver Signed: Vaccinations Verified: Please submit the completed Application, signed Liability Waiver and
More informationFRIENDLY FARMS PET RETREAT APPLICATION
APPLICATION OWNER INFORMATION Name: Address: Telephone: Home Work Cell Email Address: If we are unable to reach you, whom can we call? Please provide name and telephone number. Please provide your veterinarian
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 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 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 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 informationAllBreed s Canine Care Application
AllBreed 2357 Ventura Drive, Ste 102 Obedience & Woodbury, MN 55125 Behavioral school for dogs www.allbreedobedience.com AllBreed s Canine Care Application 651/704-9785 em: Aobedience.aol.com PLEASE PRINT
More informationDoggie Daycare/Boarding Application
Doggie Daycare/Boarding Application Date of Application: Dates of Daycare or Boarding: OWNER S INFORMATION: Name: Address: City/State/Zip: E-Mail Address: Home phone: Cell / Work phone: Persons allowed
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 information3 DOGS BOARDING AND DAYCARE
3 DOGS BOARDING AND DAYCARE Owner Information Name Address City, State, Zip Email *Would you like to be added to our email list for daycare/boarding updates and availability? Yes No (this list is for our
More informationVeterinary Group of Chesterfield Edison Ave., Chesterfield, MO
Veterinary Group of Chesterfield Daycare/Boarding Playtime Requirements Our guidelines are set forth to ensure the health and safety of all daycare participants. All dogs over 6 months of age must be spayed
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 informationDaycare & Boarding Application
Owner/Guardian Information Daycare & Boarding Application Name: Date Address: City/State/Zip: E-mail Address: Home # Work # Cell # Place of Employment: Emergency Contact: (Required-not in the same residence)
More informationEmergency Contact Name Address Home phone Cell phone
3606 NE Columbia Blvd. Portland OR 97211 email: staypetreservations@gmail.com Phone: 503-288-7829 Fax: 503-288-8374 Owner Information Name Address City, State, Zip Email Cell phone Work Phone Home phone
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 information7254 South Washington Street Grand Forks, ND (701) (701) Fax E- mail:
DAYCARE & BOARDING OWNER INFORMATION OWNER #1 ADDRESS HOME PHONE WORK PHONE CELL PHONE E- MAIL OWNER #2 ADDRESS (IF DIFFERENT THAN ABOVE) HOME PHONE WORK PHONE CELL PHONE E- MAIL EMERGENCY CONTACT (OTHER
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 informationDaycare, Boarding, Grooming, Training 6976 West 152 nd Terrace Overland Park, KS 66224
Daycare, Boarding, Grooming, Training 6976 West 152 nd Terrace Overland Park, KS 66224 Phone: 913-685-9246 (WAGN) Fax 913-685-1922 Email: info@tailsrwaggin.com Website: www.tailsrwaggin.com CLIENT PROFILE
More informationYOUR NAME: ADDRESS: HOME PHONE: WORK PHONE: CELL PHONE: DOG S NAME: AGE: BREED:
MEDICAL RELEASE FORM YOUR NAME: ADDRESS: HOME PHONE: WORK PHONE: CELL PHONE: EMAIL: DOG S NAME: AGE: BREED: THIS IS A REQUIRED FORM FOR ALL SALTY DOG DOGGY DAYCARE PARTICIPANTS RECEIVING SERVICES. First
More informationDOGTOPIA DOG ENROLLMENT FORM
DOGTOPIA DOG ENROLLMENT FORM We are thrilled your dog will be joining the fun here at Dogtopia! Please fill out the forms below, save and email to your preferred location. You can find each Dogtopia location's
More informationDOG PROFILE FORM. First Name: Last Name: Address: Home Phone: Work Phone: Cell Phone: Name: Relationship: Phone Number:
Prairie Pawz LLC 2448 Brooks Dr. Sun Prairie, WI 53590 T 608.318.3302 www.prairiepawz.com DOG PROFILE FORM CLIENT INFORMATION: First Name: Last Name: Address: City: State: Zip: Home Phone: Work Phone:
More informationWoofgang s Doggie Daycare Application
Woofgang s Doggie Daycare Application OWNER INFORMATION: Name Address City Zip Cell/Primary Phone Secondary Phone Email EMERGENCY CONTACT: Name Primary Phone DOG INFORMATION: Name Female Male Age Birthdate
More informationCAMPER PROFILE FORM CLIENT PROFILE. State Zip. Home Work Cell. Name Phone Relationship. Name Phone Relationship. Others authorized to pick-up my pet
CAMPER PROFILE FORM SNUGGLES AND HUGS 26781 HANNA RD. OAK RIDGE, TX 77386 936-443-3215 WWW.ACTIVEDOGCAMP.COM Please take a few minutes to complete this Application for your pet, one per pet please. It
More informationDOGTOPIA DOG ENROLLMENT FORM
DOGTOPIA DOG ENROLLMENT FORM We are thrilled your dog will be joining the fun here at Dogtopia! Please fill out the forms below, save and email to your preferred location. You can find each Dogtopia location's
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 informationPAW PRINTS PET RESORT GUEST APPLICATION FORM
Telephone: 250-597-DOGS Email: pawprintspetresort@gmail.com Web: www.pawprintspetresort.com PAW PRINTS PET RESORT GUEST APPLICATION FORM Date: Assessed by: Dog Information Dog s Name: Nicknames: Breed:
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 informationOwner s Name. Address. Primary Phone Alternate Phone. . Security Word (used for pick up verification) Other person authorized to pick up dog
Paws n Claws Playcare 1530 W 26 th St. Erie PA 16508 814-456-7297 fax 814-456-7299 Playcare Pet Profile Owner s Name Address City St Zip Code Primary Phone Alternate Phone Email Security Word (used for
More informationHappy Hounds Doggie Day Care, LLC
Owner Information: Address: Happy Hounds Doggie Day Care, LLC Client Info Sheet Phone: Cell: Email: Additional Owner Information: Address: Phone: Cell: Email: Dog Info: Age: Breed: Sex: Weight: Additional
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 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 informationDog Daycare. Pet Profile Enrollment Form. K-9 Kamp Downer Street Rd. Baldwinsville, NY Phone:
K-9 Kamp Dog Daycare Pet Profile Enrollment Form Please return this completed form along with a copy of your pet(s) vaccination records to: K-9 Kamp 228 Old Bridge Street East Syracuse, NY 13057 -OR- 2115
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 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 informationNew Member Registration Form
New Member Registration Form Application Process: A completed New Member Application packet must be submitted to PetCoral via email, mail or in person. Applications and vaccine records take 24 hours to
More informationNew Client Information
New Client Information Date: Primary Contact (Owner) Information Required Owner Name: Address: Apt. #: Home Phone: Work Phone: Cell Phone: Email: How did you hear about us? Emergency Contact Required Owner
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 information6 Bourbon St. D Peabody, MA CONTACT INFORMATION
6 Bourbon St. D 978-854-5812 Peabody, MA 01960 luckydogsdaycare@gmail.com Pet's Name (s) Owner's Name (s) CONTACT INFORMATION Application Address City/State Zip Phone#1 Phone#3 Phone#2 Email Address VETERINARIAN
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 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 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 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 informationDaycare & Boarding Application
Owner/Guardian Information Daycare & Boarding Application Name: Date Address: City/State/Zip: E-mail Address: Home # Work # Cell # Place of Employment: Emergency Contact: (Required-not in the same residence)
More informationLucky Dog Pet Lodge 1067 American Blvd East Bloomington, MN Phone: (952) Fax: (952) Site:
Lucky Dog Pet Lodge 1067 American Blvd East Bloomington, MN 55420 Phone: (952) 767-2040 Fax: (952) 767-2041 Site: www.luckydogpetlodge.com Enrollment Application Please complete the following questions
More informationAll dogs must be at least 8 weeks of age or older. All dogs 7 months or older must be spayed or neutered.
GENERAL INFORMATION AND POLICIES Purpose: Sunny Acres Pet Resort Doggy Day Camp provides a safe, fun and stimulating social environment for dogs. To ensure the safety and health of your pet and our other
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 informationDOG ENROLLMENT FORM PET PARENT INFORMATION
DOG ENROLLMENT FORM Please complete the following questions to the best of your knowledge. This form and the subsequent evaluation are required before your dog can stay with us. This information will help
More informationGUEST INFORMATION SHEET. How did you hear about Dogstown University? Relationship: Pet Name: Breed: Color/Markings: Approximate Weight:
DOGSTOWN UNIVERSITY 1807 South Powerline RD, Suite B-109, Deerfield Beach FL 33442 (954)-422-5764 FAX: (954)-794-0299 E-MAIL: dogstownuniversity@yahoo.com www.dogstownuniversityinc.com GUEST INFORMATION
More informationPet Personality Profile
Please complete a profile for each dog to be enrolled in day camp at The Paws Resort & Spa. Complete responses assist us in the interview process. There are no right or wrong answers as all dogs are unique.
More informationDAYCARE INFORMATION FORM
DAYCARE INFORMATION FORM BANDILANE CANINE CENTER Joyce Diamond, CPDT 80 Largo Drive, Stamford, CT 06907 ph: 203-975-8151, fx: 203-975-7457 email: info@bandilane.com www.bandilane.com OWNER S NAME ADDRESS
More informationDog Enrollment Application
Dog Enrollment Application Page 1 of 5 OWNER INFO: NAME: ADDRESS: CITY/STATE/ZIP CELL PHONE: WORK PHONE: HOME PHONE: OTHER PHONE: EMAIL: EMPLOYER: DRIVERS LICENSE #: STATE ISSUED EMERGENCY CONTACT INFORMATION
More informationDear Dog Owner: Our values are simple. We believe in: Responsible dog ownership Social responsibility Etiquette and well being Dedication Safety
Rex s Place Enrollment Application 1 Dear Dog Owner: Thank you for your recent inquiry about our dog enrichment center. At Rex s Place, we partner with owners who have a life long commtiment to socialization
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 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 informationBoarding & Daycare Contract
Boarding & Daycare Contract This is a contract between Ruff House Kennel and Daycare, LLC and the Pet Owner, or his agent. All pets are boarded, or otherwise handled or cared for, by Kennel staff without
More informationTo get started with boarding or grooming please fill out the attached Boarding and Grooming Application.
Dear New Boarding and Grooming Customers, Thank you for choosing the Prison Pet Partnership to assist you with all of your boarding and grooming needs. We strive to provide the best care possible to your
More informationDay Care/Day Training Intake Forms
Owner Information Day Care/Day Training Intake Forms Name: Address: E-Mail: Cell Phone: Work Phone: Home Phone: Veterinarian Information Clinic Name: Veterinarian s Name: Phone: Street Address: Emergency
More informationPet Profile (please print one for each pet)
OWNER INFORMATION Pet Profile (please print one for each pet) Name: Home Phone: Cell: Email: Pet s Name Breed Sex (mark one): Female Spayed Female Male Neutered Male Color: Age: #of years and months Birthdate
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 information2203 Durham Dr Houston, TX t f e.
2203 Durham Dr Houston, TX 77007 t. 713.426.5700 f. 281.501.2767 e. info@yuppiedogdaycare.com New Client Package Thank you for choosing Yuppie Dog for the care of your dog(s)! Please complete and fax the
More information2 nd Pet Enrollment Application
2 nd Pet Enrollment Application GENERAL INFORMATION Human Name: Spouse name: Email: Home phone: Cell: CANINE INFORMATION Name: Breed: Weight: Birth date: Male/Female: Neutered/Spayed: Color: Markings:
More informationYes No PATIENT INFORMATION. Dogs: Cats: Feline Rabies: FVRCP (Feline Rhinotraceitis/Calicivirus/Panleukopenia):
NEW PATIENT & CLIENT INFORMATION SHEET CLIENT INFORMATION First name Last name Spouse/Partner first name Spouse/Partner last name Address City State Zip Primary Phone # (home work cell) CIRCLE ONE *Please
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 informationDog s Name: Dear Dog Owner,
Enrollment Application p. 1 Dear Dog Owner, Thank you for your recent inquiry about our dog enrichment center. At, we partner with owners who have a lifelong commitment to socialization, training, and
More information310 Carver Lane, East Peoria, IL Phone: (309) Fax: (309)
Owner Information Owner #1 Owner #2 Name Employer Home Phone Work Phone Cell Phone Email Address Physical Residence Address (Same for both Owners) Street/City/State/Zip Mailing Address (if different) Who
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 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 informationDog Surrender Profile
Dog Surrender Profile By completing this form you are giving GAWS a written consent to relinquish all rights to your companion animal. To ensure the best possible outcome for your pet, please complete
More informationINN OF THE DOG. 865 S.W. Enterprise Way, Stuart, FL (772) Fax: (772) Innofthedog.com. Home Phone ( ) Cell Phone ( )
INN OF THE DOG 865 S.W. Enterprise Way, Stuart, FL 34997 (772) 288-1998 Fax: (772) 288-4338 Innofthedog.com 1 Owner Information Name Street Address City/State/Zip Home Phone ( ) Cell Phone ( ) E-mail address
More informationDaycare Application. Additional Owner s Name(s) authorized to drop off and pick up your dog
Fax (503) 990-6782 Daycare Application Dog s Name Date of Birth M F Breed _ Spayed/Neutered? Y N When? Weight Is your dog on a flea program? Y N If yes, product used Is your dog on a heartworm program?
More informationPuppy Play School CONTRACT
Puppy Play School CONTRACT This Contract is between the Monadnock Humane Society ( MHS ) Boarding and Daycare facility (hereinafter called the Kennel ) and the pet owner (hereinafter called the Owner ).
More informationNEW MEMBER APPLICATION
NEW MEMBER APPLICATION WEST NASHVILLE 5001 ALABAMA AVE. NASHVILLE, TN 37209 PHONE 615.334.0000 FAX 615.790.0475 TDSWEST@thedogspot.com www.thedogspot.com PARENT INFO Name(s): Address: City: State: Zip:
More informationRegistration Form. Community Event* Yelp. Advertisement* Walk/Drive-by. Other* Instagram. Rescue/Shelter*
Registration Form Owner s Name Address Home Phone # ( ) Work Phone # ( ) Cell Phone # ( ) Email Address Emergency Contact Information: (Authorized to pick-up/make decisions for dog) Name Phone # ( ) Relationship
More informationGUEST INFORMATION SHEET
DOGSTOWN UNIVERSITY GUEST INFORMATION SHEET Please complete this form and bring it with you at check-in. Owner s Name: Preferred Accommodations: Small Mini Large Mini Large X-Large Super Suite Lounge Playroom
More informationClient Information. Dog Profile
Every Client is required to read and sign this form prior to any service rendered at 20 th Street Grooming & Doggie Daycare. Thank you and we would like to Welcome you and your dog(s) to 20 th Street Grooming
More informationPlaycare, Boarding, & Dog Walking Application
Playcare, Boarding, & Dog Walking Application Dog Owner Information Name Address City State Zip Work phone Home phone Cell Phone Email address How did you hear about us? Emergency Contact Information Name
More informationFurtastik / Fuzzy Dog Dog Walking Contract & Profile
1 P a g e Furtastik / Fuzzy Dog Dog Walking Contract & Profile **Please PRINT clearly in blue or black ink. Fill in all applicable fields to the best of your knowledge*** Pet s Name Home Phone Your Name
More informationSouth Paw Doggie Daycare & Training Center
South Paw Doggie Daycare & Training Center 24210 Parker Rd * Porter, Tx 77365 * (281) 354 7768* www.puppyschool.com Daycare Application Package Thank you for your interest in our doggie daycare. South
More informationConnecticut Humane Society Canine Pet Personality Profile
Connecticut Humane Society Canine Pet Personality Profile Employee Conducting the Evaluation: The following questionnaire is used to help us learn about your dog. We use this information to help find the
More informationHappy Tail Dog Training LLC Colleen Griffith, Managing Member Canine Behavior Modification Consultation
Client Behavior History Form Happy Tail Dog Training LLC Please complete the questions below as best as you can. Canine behavior is complex; hence, this questionnaire is designed to help me understand
More informationPet Information Form. Owner Mobile.* Owner * Owner 2 Home Phone Work Phone. Owner 2 Name First..* Last * Title..*
Paws and Claws Care 15 Wordsworth Drive, Kenilworth, CV8 2TB 07895 670915 Janine@pawsandclawscare.co.uk Your Details * Required Information Pet Information Form Owner Name First..* Last * Title..* Owner
More informationDaycare/Boarding/Grooming Application to: Application may also be mailed, faxed or hand delivered
Dog Days of Birmingham 112 18th Street North Birmingham, AL 35203 Phone (205) 458 9364 Fax (205) 458-9365 www.dogdaysofbirmingham.com Doggie Day Care. Boarding. Grooming. Trainining. Retail Daycare/Boarding/Grooming
More informationNew Client Questionnaire For multiple dog owners please complete one questionnaire for each dog.
The Crate Escape, Too 1364 Marshall Ave Williston, VT 05495 802-865-DOGS (3647) The Crate Escape, Inc. 1108 West Main Street Richmond, VT 05477 802-434-6411 www.crateescapevt.com New Client Questionnaire
More informationCamp Cypress Dog Retreat
Client Information Form CONTACT INFORMATION Address: City, State Zip: Home Phone: Mobile Phone: Can we text this number? Y N Email: Alternate Contact: Address: City, State Zip: Home Phone: Mobile Phone
More informationPlease read and answer ALL questions. You can use a? or NA when applicable. Guardian/Human's Name: Mailing Address: City/Town State Zip
New Doggy Dude Existing Dude's Updated Information Additional Doggy Dude Please read and answer ALL questions. You can use a? or NA when applicable. Guardian/Human's Name: Mailing Address: City/Town State
More informationRocky s Retreat Boarding/Daycare Intake Form
Rocky s Retreat Boarding/Daycare Intake Form (please complete entire form) Date: / / Owner/Guardian Mailing Address City State Zip Home Phone Work Cell Phone Email Address How long have you had your dog?
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 informationCamp K-9 Pet Resort General Information and Policies. Boarding Grooming Day camp Training. Please keep this sheet for your records
Camp K-9 Pet Resort General Information and Policies Boarding Grooming Day camp Training Please keep this sheet for your records Thank you for choosing Camp K-9 Pet Resort. The purpose of Camp K-9 is to
More information*Please Complete This Form* Owners Name: Address City : State : Zip : Home Phone : Business Phone : Cell Phone :
! Page 1 *Please Complete This Form* Owners Name: Address City : State : Zip : Home Phone : Business Phone : Cell Phone : Email : Dog s Information: Name of Dog(s) : Breed(s) : Weight : Color : Birth Date
More informationKRANKY K9 DOG TRAINING AND REHABILITATION. BOARD & TRAIN CONTRACT (Please PRINT all Information)
Owner s First Dog s Address: City: Home Ph#: KRANKY K9 DOG TRAINING AND REHABILITATION BOARD & TRAIN CONTRACT (Please PRINT all Information) Last State : Zip: Work Ph#: Email : Cell Ph#. Dog s Age: Breed:
More informationPooch Personality Profile
Pooch Personality Profile Complete a profile for each dog enrolled at Urban Tails. Complete responses assist us in providing high quality care for your dog. There are no right or wrong answers as all dogs
More informationBEHAVIOR ASSESSMENT INTAKE FORM
BEHAVIOR ASSESSMENT INTAKE FORM Your Name: Date: Address: Phone # City: Zip: Who referred you to us? DOG INFORMATION Dog of concern; Name, Breed, Sex, Weight and Age: How long have you owned or fostered
More informationThe Scruffy Puppy Hazlet, NJ scruffypuppypetcare.com
The Scruffy Puppy Hazlet, NJ 732-520-0454 scruffypuppypetcare.com In Home Dog Boarding Application & Agreement *Please PRINT clearly in blue or black ink & Fill in all applicable fields to the best of
More informationOWNER SURRENDER FORM
P.O. Box 110987 Naples Florida 34108 Phone/Fax: 239-369-0415 info@grrswf.org www.grrswf.org OWNER SURRENDER FORM We understand that giving up your pet is a difficult decision, but we realize that in making
More informationOff-Leash Play Application
Off-Leash Play Application We love dogs and want your dog to love coming to our off-leash playgroup. No one knows your dog better than you, so we d appreciate you taking the time to fill out this application.
More information