Stay & Play Dog Hotel and Daycare Registration

Stay & Play Dog Hotel and Daycare Registration

Please complete all the required fields below and submit your application for review.
Owner Information:
Owner's Name:*

First NameLast Name
Primary Phone Number*
Please enter a valid phone number.
Secondary Contact*

First NameLast Name
Secondary Phone Number*
Please enter a valid phone number.
Address:*

Street Address

Street Address Line 2

CityState

Postal / Zip CodeCountry
E-mail*
Emergency Contact Name (Not traveling with you)*

First NameLast Name
Emergency Contact Phone:*

Area CodePhone Number
Pet Information:
Pets Name: (If you have two dogs please list both here)*
Breed: (If you have two dogs please list both here)*
Age/DOB:*
Vaccinations*

Kennel Cough (Bordetella)RabiesDistemper (DHPP)
Spayed/Neutered?:*

YESNO
Vet Information (Name, Address, Phone):*
Any Medical Problems / Special Conditions / Allergies?*
Has your dog attended a daycare program?

YESNO
If YES, where? Why no longer attending?
Negative experiences with other people/animals/dogs? (Even if not liable) Explain:
Use of training collars or CBD at home to manage behavior?*

YESNO
Any known aggressive behavior regarding:*

NoneFoodLeashResourceMenWomenLarge DogsSmall DogsOther
If aggressive/anxious behavior not listed, please explain:
Anxiety Triggers?*
Body handling issues? (ex: feet, collar area)*
Crate trained? (Boarding dogs need to be in order to pass temperament visit)*
Daycare & Boarding Requests
Days anticipating day play

MondayTuesdayWednesdayThursdayFridayWeekends
Half or Full Days?

Half Days (up to 5 hours)Full Days
How often anticipated usage of day play? (ex. 1-2 days a week)
Do you anticipate future boarding? If so, when and how often?
Where did you hear about us from? If from another client, please list who.
SERVICE AGREEMENT:
I hereby certify that my dog(s) is (are) in good health, and have not been ill with any communicable condition in the last 30 days. I further certify that my dog(s) has/have neither harmed nor shown aggressive or threatening behavior toward any person or any other dog. I have read and I understand the following:
1. I understand that I am solely responsible for harm caused by my dog(s) while my dog(s) is/are attending Stay & Play
2. I further understand and agree that in admitting my dog(s) to Stay & Play, the staff has relied on my representation that my dog(s) is/are in good health and has/have not harmed nor shown aggressive or threatening behavior toward any person or any other dog.
3. I further understand and agree that Stay& Play is a cage free facility and my dog(s) will play in open areas with other dog(s). I accept the risks involved and agree that Stay & Play and its staff will not be liable for any problems which develop (provided reasonable care and precautions are followed) and I hereby release them of any liability of any kind whatsoever arising from my dog(s) attendance and participation at Stay & Play
4. I further understand and agree that any problems, which develop with my dog(s), will be treated/handled as deemed best by the staff of Stay & Play at their sole discretion and that I assume full financial responsibility for any and all expenses involved.
5. I further understand and agree that that if my dog displays aggressive behavior, that for the safety and health of my dog and others, my dog will either be confined to a separate room (with human attention), for a portion of or the remainder of his/her stay with no offset or deduction in price, or be disqualified as a Stay & Play customer.
6. I further understand and agree that Stay & Play may record or reproduce the image and sound of my dog(s) while at our facility, and Stay & Play shall own all rights, title and interest in the imagery. I further agree and consent that my dog(s)may be used by Stay & Play to advertise, publicize or otherwise promote Stay & Play
I certify that I have read and understand the policies of Stay & Play as set forth on the preceding pages and that the information I have provided is true to the best of my knowledge; and that I have read and understand the conditions and statements of this agreement including the following:

Fees: I understand that fees are based on packages purchased and all policies of refund are posted on our website or can be available upon asking.

Day Play -Days and Hours (no reservations necessary): I understand that the days and hours that Stay & Play is open for daycare are Monday through Friday 7:00 AM to 6:00 PM Monday through Friday and 7:00AM to 5:00PM on weekends. I also understand that Stay & Play is closed to the public at 6:00 PM.

Boarding Reservations: I understand that as a smaller, personal facility, Stay & Play must rely on reservations so that our numbers remain consistent therefore last minute or consistent cancellations will result in loss of deposit or store credit and possibly the ability to book for boarding.
Owner's Signature:*

Clear
Date:*

MonthDayYear
Date
Authorization for Emergency Medical Treatment:
The undersigned Owner, of the animal named above, hereby authorizes a licensed veterinarian, and whoever may be designated as assistants, to administer such treatments and to perform such procedures as are considered therapeutically or diagnostically necessary for the care of my animal, including the administration of anesthesia. In the event that emergency treatment is required, I authorize the veterinary staff and their assistants to perform medical and surgical treatments necessary to preserve the life of the patient until I can be contacted for further authorization.

I understand that no guarantee of successful treatment is made. I accept financial responsibility for the treatment of the above named patient, and I understand that payment in full is due upon release of the patient from the veterinary hospital, or when service is otherwise terminated I understand that I am entitled to a written estimate of charges at my request.

Veterinary service is provided during nighttime hours as necessary in the judgment of the veterinarian in charge. Continuous presence of qualified personnel may not be provided.
Emergency Medical Treatment Authorization:*

I certify that I have read and understand the terms and conditions stated in this agreement, and acknowledge that this agreement shall be effective and binding upon the parties. I hereby release Stay & Play and all staff from any and all claims arising out of such an emergency situation.
Owner's Signature*

Clear
Date:*

MonthDayYear
Date
Medical Information Release:
Emergency Medical Treatment Authorization:*

I hereby certify that I am the owner (Pet Parent) or authorized agent of the Pet Parent of the above described pet(s). Further, I hereby request and authorize this veterinarian to release the requested medical information for above described pet(s) to Stay and Play. I release the veterinarian and staff from any legal responsibility or liability for the release of information to the extent indicated as authorized herein.
Owner's Signature*

Clear
Date:*

MonthDayYear
Date
This form is to be completed by all customers otherwise pets will not be able to attend boarding or daycare. You are required to call after completeing the form to be enrolled in our facility. All dogs must complete a temperament visit before any guarentees are made for reservations. Thank you!
Once you submit your application, we will contact you shortly to complete your membership application. Thank you!
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Stay & Play Dog Hotel and Daycare Registration

Owner Information:

Pet Information:

SERVICE AGREEMENT:

Authorization for Emergency Medical Treatment:

Medical Information Release: