Client Onboarding Form 2022R1
  • Date*
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  • How did you hear about Jasper's Splash Zone?*

  • Do we have your permission to add your name to our e-mail list*
  • Male / Female*
  • DOB*
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  • Neutered / Spayed*
  • TITERS: If are providing titer dates below instead of vaccination dates, please check the YES box; otherwise check NO*
  • Rabies Vaccine Expiration OR Titer Date?*
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  • Distemper-Parvo Vaccine Expiration OR Titer Date*
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  • Bordetella Expiration Date
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  • Has your dog bitten a human?*
  • Has your dog bitten another dog?*
  • Is your dog reactive to: (select all that apply)*
  • Does your dog have any condition that we should be aware about such as recent surgery, injuries, treatment, been sick or is taking daily medication?*
  • Is your dog under the direct care of a veterinarian for any current conditions*
  • If 'Yes', do you have consent from your veterinarian to swim or participate in active dog activities?*
  • Is your dog allergic to any treats?*

  • Please review our Rules & Policies:

  • IMPORTANT: Please read our Liability and Assumption of Risk and Indemnity Agreement:

  • Should be Empty: