INN OF THE DOG. 865 S.W. Enterprise Way, Stuart, FL (772) Fax: (772) Innofthedog.com. Home Phone ( ) Cell Phone ( )

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Transcription:

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 Does anyone, besides the owner, have permission to pick up your pet? No, please provide names How did you hear about Inn of the Dog? Emergency Contact Information Incase You Are Not Available 1. Name Phone ( ) 2. Name Phone ( ) Veterinary Information Vet Name Vet Practice Phone ( ) Please Note The Following Requirements All dogs must be current on DHLPP, RABIES, and BORDETELLA vaccinations. Bordetella should be administered within the past six months, and at least five days prior to daycare or boarding. Proof of vaccinations is required. All dogs over the age of 10 months should be spayed or neutered in order to participate in daycare activities. All dogs must meet temperament criteria for participation in daycare activities. All dogs must be free of fleas and ticks and on preventative. If fleas and/or ticks are discovered on your dog while under our care, a flea/tick bath will immediately be given and you will be charged accordingly.

Dog #1 (forms for additional dogs located after page 3) 2 Has your dog ever climbed/jumped a fence? No, what height? Does your dog play with toys? No Does your dog share food/toys with other animals? No Has your dog ever had formal obedience training? No House Training No Territorial Marking No Barking No Digging No Chewing No Ignoring Commands No Frightened By Noises No Does your dog have any sensitive areas on his/her body? No, explain What type of food do you feed your dog?

3 INN OF THE DOG WAIVER As a condition of using our services for your pet(s), the following wavier and assumption to hold harmless must be signed. I understand that I am solely responsible for harm or damage caused by my dog(s) while my dog(s) is under the supervision and care of Inn of the Dog and its employees. I understand and agree that the Inn of the Dog has relied on my representation that my dog(s) is in good health, fl ea and tick free, and has not harmed or shown aggression or threatening behavior towards any person or any other dog. I understand and agree that the Inn of the Dog and its staff will not be held liable for any problems that develop provided reasonable care and precautions are followed, and I hereby release the Inn of the Dog and its employees from any and all liability of any nature whatsoever arising from my dog s attendance and participation at Inn of the Dog. I understand and agree that any problem that develops with my dog(s) will be treated as deemed best by staff of Inn of the Dog, in their sole discretion, and that I assume full fi nancial responsibility for any and all expenses involved. In the event of an emergency, I hereby authorize medical treatment be administered to my dog(s) by a veterinarian at my expense. I understand that my dog may be at risk for cuts, scrapes, scratches, and/or bruises associated with daycare activities at Inn of the Dog. Owner Signature Owner Name (printed) Date / /

Dog # 2 4 Has your dog ever climbed/jumped a fence? No, what height? Does your dog play with toys? No Does your dog share food/toys with other animals? No Has your dog ever had formal obedience training? No House Training No Territorial Marking No Barking No Digging No Chewing No Ignoring Commands No Frightened By Noises No Does your dog have any sensitive areas on his/her body? No, explain What type of food do you specifi cally feed?

Dog #3 5 Has your dog ever climbed/jumped a fence? No, what height? Does your dog play with toys? No Does your dog share food/toys with other animals? No Has your dog ever had formal obedience training? No House Training No Territorial Marking No Barking No Digging No Chewing No Ignoring Commands No Frightened By Noises No Does your dog have any sensitive areas on his/her body? No, explain What type of food do you specifi cally feed?

Dog #4 6 Has your dog ever climbed/jumped a fence? No, what height? Does your dog play with toys? No Does your dog share food/toys with other animals? No Has your dog ever had formal obedience training? No House Training No Territorial Marking No Barking No Digging No Chewing No Ignoring Commands No Frightened By Noises No Does your dog have any sensitive areas on his/her body? No, explain What type of food do you specifi cally feed?

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