Application to join Wag n Tails
Applicant Agreement
I understand that I am solely responsible for any harm caused by my dog(s) while my dog(s) is/are attending daycare at Wag'n Tails Chicago. I also understand and agree that in admitting my dog(s), Wag'n Tails Chicago has relied upon my representation that my dog(s) is/are in good health and have not harmed or shown aggressive or threatening behavior towards any person or any other dog. I further understand that due to the way that dogs interact with one another, minor cuts and scratches can occur even though the dogs are carefully supervised at all times. While my dog(s) is/are in the care and custody of Wag'n Tails, if I am unreachable in the event of an emergency, I hereby authorize Wag'n Tails, its agents, and/or representatives to seek immediate veterinary care for my dog. I understand that all costs in connection with, veterinary, medical or other treatment shall be my responsibility. I hereby release and agree to save and hold harmless, Wag'n Tails Chicago, it’s directors, officers, shareholders, employees, assistants, members and agents from any and all liability, claims, suits, actions, loss, injury or damage of any nature or kind, or for any liability, claims, suits, actions, loss, injury or damage which I or my dog(s) may sustain or which may be caused in any way by my dog(s). I specifically, without limitation, agree to fully indemnify Wag'n Tails Chicago for any and all such liability, claims, suits, actions, losses, injury or damage. I certify that I have read and understand the rules and regulations set forth herein and that I have read and understand this agreement. I agree to abide by the rules and regulations and accept all the terms, conditions and statements of this agreement and confirm the truthfulness of the contents of the Application form completed by me. Although we carefully screen all applicants, occasionally we discover that this is not an appropriate environment for every dog. Wag'n Tails reserves the right to permanently remove a dog from daycare at any time. In addition, Wag'n Tails Chicago reserves the right to disallow certain breeds to participate in the daycare. Wag'n Tails Chicago requires a two-day minimum per week (for daycare) all year long.
Owner Name:
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number (Mobile)
*
-
Area Code
Phone Number
Phone Number (Work)
-
Area Code
Phone Number
E-mail
*
example@example.com
Emergency Contact:
*
First Name
Last Name
Emergency Contact:
*
-
Area Code
Phone Number
Emergency Contact Email:
*
example@example.com
Pet's Details
Name of the Pet
*
What is the breed of your pet?
*
Pet's Age
*
Pet Weight
*
Pet's Sex
*
Male
Female
Is your pet spayed / neutered?
*
Yes
No
My pet is vaccinated for the following:
Distemper
Rabies
Parvo Virus
Bordetella (kennel Cough)
Other
Attach proof of vaccines and other medical records.
*
Upload File
Cancel
of
Is your pet used to other pets?
Yes
No
Other
Do you have a regular veterinarian?
*
Yes
No
Veterinarian’s name
*
Clinic Name
*
Clinic's Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Clinic's Telephone
*
-
Area Code
Phone Number
Pet's Details (include allergies)
Pet's Interactions
Has your dog been to any dog parks? If so, how did they play and interact with the other dogs?
Has your dog ever attempted to bite another dog or person? If yes, please explain.
Is your dog toy or food possessive? If yes, please explain.
Has your dog ever been in a fight with another dog? If yes, please explain.
Are there any medical conditions we need to know regarding your dog? If yes, please explain.
Does your dog have any problems with dogs smaller or larger than they are?
Wag'n Tails may be picking up and dropping off your dog. Do you have any special requests? (i.e. alarm code set or disarm, heat/ac, television, etc.)
How did you hear about us?
Indicate days interested in services
Monday
Tuesday
Wednesday
Thursday
Friday
Other
I herby agree that my signature verfies that the following statements are true. I agree to the terms and legal agreements as metioned above.
Submit
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