subject_line
Boarding & Daycare Agreement
Please fill out this online form and submit or if preferred you
may print/fill out a PDF form instead by
clicking here
.
Owner Information
First Name
*
Last Name
*
Street Address
*
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
*
Primary Phone
*
Alt Phone
Email
*
Confirm Email
*
How did you hear about us?
Emergency Contact (if other than owner)
Emergency Contact Name
Emergency Contact Phone
Requested Boarding/Daycare Dates
Are you requesting boarding or daycare?
*
Boarding
Daycare (no overnight boarding)
Overnight Kennel type?
*
Rec Kennel (dogs between 40lbs - 100lbs)
Regular Suite (dogs 100lbs or less)
Luxury Suite (any size dog including 100lbs+)
Tiny Town (small dogs - 25lbs and under)
NOTE:
Requested dates do not guarantee booking. Booking is dependent on the space we have available.
Requested Check-in Date:
*
+
Requested Check-out Date:
*
+
Dog Information
Dog's Name
*
Breed
*
Weight
*
Color
*
Birth date
*
+
Sex
*
Male
Female
Spayed/Neutered?
*
Neutered (Male)
Spayed (Female)
Unaltered
Method of flea control (all dogs must be on a flea medicine)
*
Does your dog have an I.D. tag?
*
Yes
No
Has your dog ever had kennel cough?
*
Yes
No
Is your dog house broken?
*
Yes
No
Has your dog ever been boarded or attended doggie daycare?
*
Yes
No
Has your dog ever bitten a person or another dog?
*
Yes
No
Has your dog ever been aggressive towards people or other dogs?
*
Yes
No
You answered yes, please explain (aggressive)
*
Is your dog a jumper, climber, or escape artist?
*
Yes
No
You answered yes, please explain (jumper, climber, escape artist)
Please describe any physical or medical issues (including seizures, asthmatic symptoms, pancreatitis, separation anxiety, food allergies, etc.)
Secondary Dog Information
Do you have another dog you want in boarding and/or daycare?
*
Yes
No
Dog's Name
*
Breed
*
Weight
*
Color
*
Birth date
*
+
Sex
*
Male
Female
Spayed/Neutered?
*
Neutered (Male)
Spayed (Female)
Unaltered
Method of flea control (all dogs must be on a flea medicine)
*
Does your dog have an I.D. tag?
*
Yes
No
Has your dog ever had kennel cough?
*
Yes
No
Is your dog house broken?
*
Yes
No
Has your dog ever been boarded or attended doggie daycare?
*
Yes
No
Has your dog ever bitten a person or another dog?
*
Yes
No
Has your dog ever been aggressive towards people or other dogs?
*
Yes
No
You answered yes, please explain (aggressive)
*
Is your dog a jumper, climber, or escape artist?
*
Yes
No
You answered yes, please explain (jumper, climber, escape artist)
*
Please describe any physical or medical issues (including seizures, asthmatic symptoms, pancreatitis, separation anxiety, food allergies, etc.)
Authorized Individuals Release Consent
Authorized Individuals Release
By checking here, you authorize the Facility to release your dog to someone other than the person(s) listed above, and you release the Facility of and from any and all responsibility for releasing your dog to any person they believe to be authorized by you.
List all authorized individuals:
(if adding multiple people, separate each person with a comma)
*
Preferred Vet Clinic
NOTE:
We require proof of vaccinations (Rabies, DHLPP, Parvo, Bordetella) to be brought in on your dog's first visit. Please upload or bring copies in with you in person.
Vet Name
Vet Phone
Vet Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
Upload Vet Records