PERFECT PLACE BOARDING KENNEL REGISTRATION FORM Client Name Mailing Address Postal code Phone Cell Emergency contact Phone Vet Phone Dog's Name D.O.B Sex Breed Colour Vaccinations UP TO DATE: DHLPP, Distemper, Hepatitis, Parvo, Parainfluenza, Bordetella, Rabies (Witnessed by staff member) (Print name) How did you hear about us? Terms of Agreement Perfect Place Boarding Kennel will provide a clean, safe, and comfortable environment for your pet. If you're pet should develop a medical problem or become injured while in our care, all reasonable efforts will be made to contact the pet owner and/or the emergency contact provided. Failing to reach either we will contact a veterinarian. If it is an emergency situation we will provide immediate medical care. Round trips to the vet and associated vet costs are the responsibility of the pet owner and will be included in the boarding invoice. If the guest is picked up prior to the date specified and you have not provided 24 hours notice, a full day will be charged. Check out time is 2 pm. A full day will be charged for pickups after 2pm. Customers are asked to provide their own pet food to avoid an up-set. If required, we will provide food at a charge of $3.00 per day. (We do not accept checks). We DO NOT accept responsibility for any injury, death, and property damage or loss sustained by you or your pet, which may occur because you used our services, unless we have been unreasonably negligent. Note--- Please note that there is a service charge for After Hrs service and must be pr-approved 48hrs in advance. Owner Signature
Name of Guest Breed D.O.B MEDICATIONS PET NOTES FEEDING INSTRUCTIONS IMPORTANT INFO Please circle answers F M Spayed/Neutered No Yes Has your dog ever shown aggressive behavior to a person? Yes No Has your dog ever shown aggressive behavior to a dog? Yes No Is there something that will trigger your dog like seeing a Cat, car, bicycle, horse, Cow, thunder or Dog? Yes No If yes explain Has your dog ever bitten a person or dog? If yes explain
BEHAVIOR HISTORY DOG NAME BREED DATE F-SPAYED? Yes No M-Neutered? Yes No (1) How old was your dog when you got him? D.O.B (2) Where did you buy your dog? Colour Pet Store Breeder S.P.C.A. Other (3) Is your dog friendly towards other people? Yes No? (4) Is your dog friendly towards other dogs? Yes No (5) Ever bit or attempted to bite another dog or person No Yes Muzzle (6) Is your dog ever afraid, skittish or Shy? Yes No (7) Is your dog aggressive when frightened? Yes No (8) Has your dog nipped you or others? Yes No (9) Does your dog have any illness or physical handicap? Yes No If yes explain (10) AGE REMOVED FROM LITTER LENGTH OF STAY TWO WEEKS recommended for ground work then a maintenance program to follow. NOTES
Doggie Camp Training Assessment / Placement To all customers of Perfect Place Kennels: It is important for your dog to have positive social skills before participating in our general doggy camp; for the safety of other dogs, your dog and our staff. Some dogs that come to stay are not suitable for the general program. An example would be a dog showing aggressive or timid behavior. That requires using our K9 counselors and professional trainers. There is an additional fee of $3.00 per day for this program, and only if it is necessary will your dog be upgraded to this behavior modification program. Once your dog is ready he will be placed back into the general program at the lower price. Note - if your dog has severe aggression issues, a private consultation is mandatory before entering any camp program. By signing below you agree we may take the necessary steps if needed to help your dog achieve stronger social skills. If you do not agree he will be removed from the general program. Please sign and date below: Name of dog Print name of owner Date Signature of owner
APPROVED PICK UP LIST PLEASE PRINT OWNERS FULL NAME NAME OF DOG This will authorize the person to pick your dog up in your absence. MUST HAVE MATCHING PHOTO ID NAME PHONE 1 st 2nd 3rd 4th 5th OWNERS SIGNATURE