DOG DAYCARE APPLICATION FORM

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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 Contact) Name: Home Phone ( ) - Other Person Authorized to Pick Up: Veterinarian: Name: Phone ( ) PET INFORMATION Name: Breed: Color: Weight: Spayed/Neutered Y / N Birthday: Sex: M / F Immunization (expiry dates please). If you do no know we can call your veterinary. Rabies: Distemper: Parvovirus: Hepatitis: Parvoinfluenza: Bordetella: Is your dog allowed to have treats? Y / N (if yes, what type) If you have not had him/her from puppy hood, what do you know of its prior history? Please describe your dogs overall temperament: How does your dog react to other dogs? (Generally)

Has your dog every participated in play at a dog park? Y / N If yes how did he/she react with the other dogs? How does your dog react to strangers? Does your dog have any kinds of people he/she automatically fears or dislikes? Y / N Does your dog have any kinds of dog that he/she automatically fears or dislikes? Y/N Has your dog ever bitten someone, even by accident? Y / N Has your dog ever been in a fight or bitten another dog, even by accident? Y / N Has your dog ever been resistant, growled, or snapped when: a) Toys are removed? Y/N b) Disturbed while resting or sleeping? Y/N c) Physically removed from a location by the collar? Y/N d) Touched when fixated or focused on something? Y/N How much exposure has your dog had to other dogs throughout his life? Describe: Does your dog get along with other dogs? Y/N a) How often does your dog meet other dogs? b) Has your dog interacted with dogs of various sizes? c) Has your dog interacted with dogs of the same and opposite sex? Is your dog toy possessive? Y / N Describe: Has your dog shared toys/food/water with other dogs before? Y / N Were there any problems? Does your dog have any health concerns that you are aware of? Y / N Does your dog have any medical restrictions on his/her activities? Y / N Is your dog currently on any medication? Y / N Does your dog have any areas on his/her body that he/she does not like to be touched? Y/N

Does your dog receive flea and tick preventative? Y / N Is there anything else that you believe we should know about your dog? When would you like to start? The Hound Lounge 80 Ellis Dr., Unit 1 Barrie, Ontario L4N 8Z3 705-728- 5211 www.hound- lounge.ca info@hound- lounge.ca

DOG DAYCARE, PET CARE AGREEMENT Your Name: Address: Home Phone ( ) - Dogs Name: Age: Breed: 1. I further understand that THE HOUND LOUNGE INC. has relied upon my representation that my dog is in good health and has not injured or shown aggression or threatening behavior to any person or dog in admitting my dog for services at their facility. 2. I further understand that THE HOUND LOUNGE INC., their owners, staff, partners and volunteers, 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 HOUND LOUNGE INC. I hereby release THE HOUND LOUNGE INC. from any liability of any kind arising from my dogs participation in any and all services provided by THE HOUND LOUNGE INC. 3. I further understand and agree that any problems with my dog, behavioral, medical or otherwise will be treated as deemed best by staff of THE HOUND LOUNGE INC. in there sole discretion, and in what they view as the best interest of the animal. I understand that I assume full financial responsibility and all liability for any and all expenses involved in regards to the behavior and health 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 desire a socialized environment for my dog while attending services provided by THE HOUND LOUNGE INC. and while in their care. I understand that while the socialization and play is closely and carefully monitored by The Hound Lounge staff to prevent injury, it is still possible that during the course of normal play my dog may receive minor nicks and scratches from roughhousing with other dogs. Staff will, upon pick- up, point out any injuries to my dog. 5. I understand by allowing my dog to participate in services offered by THE HOUND LOUNGE INC., I hereby agree to allow THE HOUND LOUNGE INC. to take photographs or use images of my pet in print form or otherwise 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 HOUND LOUNGE INC. 7. I understand that if my dog is not picked up on time, I hereby authorized THE HOUND LOUNGE INC. to take whatever action is deemed necessary for the continuing care of my dog. I will pay THE HOUND LOUNGE INC. the cost of any such continuing care upon demand by THE HOUND LOUNGE INC. This is a required form for all THE HOUND LOUNGE INC. participants receiving services. First and foremost the safety and well- being of your pet(s) is of the highest importance. Ensuring that your pet remains safe and well cared for is our first responsibility and as such we take it very seriously. We do our best to have our pet parents screen for pre- existing health conditions but some factors may be beyond our control. In the event that a medical emergency arises while a pet is at our facility or participating in a service that we provide, it is imperative that we are immediately able to get them medical treatment at the closest available facility. We will call ahead to the veterinary offices in closest proximity geographically to us to insure they can handle the emergency present. Your pet will be rushed to the closest available facility for treatment and you will be notified. We notify the owner after we have secured a medical treatment center for the animal to avoid delays that may be caused by emotion on the part of the owner. Our goal is to get your pet medical attention as quickly as humanly possible, and any distractions may interfere with that process. For that reason it is a requirement to have our pet parents sign this form. I understand that in the event of a medical emergency, that THE HOUND LOUNGE INC. at its sole discretion deems to need the immediate attention of a licensed veterinarian. I authorize THE HOUND LOUNGE INC. to seek medical attention at the closest available veterinary facility. I further agree that I am financially responsible for any medical treatment my pet(s) receives as a result of a medical emergency while attending services provided by THE HOUND LOUNGE INC. Signature of Owner Date Printed Name:

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