Daycare and Boarding Assessment Request/Enrollment Form

I'm a*

New ClientReturning Client with Returning PetReturning Client with New Pet

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Home Phone Number

Area CodePhone Number

Cell Phone Number*

Area CodePhone Number

Work Phone Number

Area CodePhone Number

Place of Employment

Is there an Additional Owner?

YesNo

Additional Owner Name

First NameLast Name

Additional Owner Email

example@example.com

Additional Owner Cell Phone Number

Area CodePhone Number

Emergency Contact - If we are unable to contact you*

First NameLast Name

Emergency Contact Phone Number*

Area CodePhone Number

My preference of contact is:

Phone CallTextEmail

How Did You Find Us?*

Trainer/Vet/Human or Pet's Name so we can give them credit*

Dog's Name*

Dog's Sex*

MaleFemale

Is your dog spayed or neutered?*

YesNo, but will be by 7 months of ageNo, but will be eventuallyNo, I have no plans to spay/neuter my dog

Dog's Breed*

Color/marking*

Age

Dog's Birthday*

Date

When did your dog join your family?*

Date

Where did you obtain your dog? (rescue, breeder, stray, gift, petshop, etc)*

Weight*

Which of our services are you interested in?*

Does your dog like humans?*

Loves them allTakes a minute to warm upOnly likes those they are familiar withAvoids all human interactionNervous enough to have bit or nipped a human in the past

Does your dog enjoy the company of other dogs?*

Thinks everyone is a friendHas limited experience but seems toTakes a minute to warm upOnly likes select dogsI have no idea yetNot really, prefers space from othersHas bitten or nipped at other dogs in the past

Is your dog allowed treats?*

YesNo

Please choose all that apply to your dog

Are there any medical/health conditions that would affect their time here?*

What happens when you or somebody else tries to take food or toys from your dog?*

How often does your dog play with other dogs and what kind are they?*

Has your dog attended daycare before?*

YesNo

What was the name of the facility and what was their experience?*

Has your dog boarded before?*

YesNo

What was the name of the facility and what was their experience?*

Has your dog ever been dismissed from a daycare or boarding facility?*

YesNo

Please explain the circumstance in as much detail as you can. *

Does your dog attend a local dog park?*

YesNo

Has your dog attended training classes?*

YesNo

What is the name of the trainer or training facility?

Has your dog ever bitten a human?*

YesNo

What were the circumstances?*

Has your dog ever bitten another dog?*

YesNo

What were the circumstances?*

Has your dog ever jumped or climbed over a fence?*

YesNo

How high was it?*

How do you feel daycare is going to benefit your dog?*

Vaccination Record*

Browse Files

Please upload your vaccination records here. We will need to see these before setting up your assessment.

Is there anything we need to know before the assessment? Drop us a note here!

4-LEGGED FRIENDS DAY CARE, LLC Owner's Release and Waiver of Liability

(Please Read Carefully this Is a Legal Document)

THIS RELEASE AND WAIVER OF LIABILITY (the “Release”) is executed on this

Date*

Date

Name*

First NameLast Name

In consideration of 4-LEGGED FRIENDS DAY CARE, LLC (the Releasee, hereinafter “4-LFDC”) permitting the undersigned (the Releasor, hereinafter “Owner”) and the Owner’s dog(s), cat(s), and/or other pet(s) to enter onto the facility/property operated by 4-LFDC, and 4- LFDC whose registration process requires acceptance of this agreement; Owner hereby freely, voluntarily and without duress executes this Release and Waiver under the following terms:

1. Waiver and Release. Owner and his/her family members, significant others, cohabitaters, co-owners, agents, representatives, etc. (Collectively, the Releasor, hereinafter “Owner”) release, forever discharge, and hold harmless 4-LEGGED FRIENDS DAY CARE, LLC a limited liability company and its members, directors, officers, employees, agents, contractors, volunteers, representatives, affiliates, successors and assigns, etc. (Collectively, the Releasee, hereinafter “4-LFDC”), in their individual and/or limited liability company/corporate capacities from any and all causes of action of any nature and kind, including attorney fees, resulting from any and all injury, illness, death, property damage, or loss of any kind whatsoever to Owner or Owner’s pet(s), known or unknown, either in law or in equity, which arise or may hereafter arise from Owner’s or Owner’s pet(s) attendance, care, entry upon, use of, or participation in any activities, etc. by 4-LFDC on the property operated by 4-LFDC.

2. Assumption of risk. Owner understands and acknowledges that Owner or Owner’s pet(s): (a) may come in contact with communicable diseases/illnesses including, but not limited to: Distemper, Parvo, Bordetella (“kennel cough”), Rabies, COVID-19, etc.; (b) may be injured or die due: to interaction with other animals on the property operated by 4-LFDC, exposure to diseases/illnesses listed above, every day living events, pre-existing medical conditions, etc.; ( c) vaccines do not protect against all communicable diseases/illnesses and puppies which have not completed a full series of vaccinations are more susceptible; (d) by entering the property operated by 4-LFDC, Owner assumes these and any and all other risks and dangers, known or unknown, and all responsibility for any losses and/or damages, whether caused in whole or in part by other animals, 4-LFDC, or any other person who is permitted on to the property.

3. Veterinary Treatment. In the event that Owner’s pet(s) becomes ill or injured while under the care of 4-LFDC, Owner authorizes 4-LFDC, at its sole discretion, to seek and to obtain veterinary treatment/care for Owner’s pet(s) and Owner shall be responsible and shall promptly pay for any and all costs incurred. Further, Owner hereby releases and holds harmless 4-LFDC and any treating veterinarian/veterinarian clinic from any and all claims arising out of any veterinarian treatment/care provided hereunder, actions, omissions, or decision not to seek veterinary treatment/care.

4. Indemnification. Owner is responsible for any harm of any kind caused by Owner’s pet(s) while attending 4-LFDC and/or while on its property. Owner is solely responsible for any and all acts or behavior of Owner’s pet(s) while attending 4-LFDC and/or while on its property. Owner shall indemnify, defend, and hold harmless 4-LFDC from any and all claims, losses, expenses, attorney fees, etc. resulting from Owner and/or Owner’s pet(s) for any
reasons whatsoever including, but not limited to: aggressive behavior, pre-existing conditions/illnesses/diseases, newly acquired conditions/illnesses/diseases, failure to advise 4-LFDC of conditions/illnesses/diseases, harm caused to other animals/individuals, etc.

5. Pick up. Owner will pick up Owner’s pet(s) by closing time or Owner’s pet(s) will be boarded overnight at the normal rate.

6. Personal Effects. 4-LFDC shall not be responsible for lost or damaged personal items including, but not limited to: leashes, collars, blankets, toys, etc., brought to 4-LFDC by Owner. Any and all personal effects/items left with 4-LFDC will be held for a period of 30 days, at which point such shall be deemed abandoned and 4-LFDC shall have immediate right to dispose of such in any manner that it deems appropriate without liability.

7. Admittance. 4-LFDC reserves the right to refuse admittance to any animal that lacks proof of vaccinations, demonstrate signs of illness/disease, demonstrates aggressive behavior, appears injured, etc. Owner agrees that 4-LFDC reserves the right to require Owner and/or Owner’s pet(s) to leave 4-LFDC and its property due to unacceptable behavior, health, illness, injury to Owner’s pet(s) or other persons or animals at 4-LFDC’s sole discretion.

8. Photographic Release. Owner’s pet(s) may be videotaped, photographed, recorded, etc. 4-LFDC shall be the exclusive owner to the results, including, but not limited to: any and all royalties, proceeds, other benefits, etc. of such tapings, photography, audio, recordings, etc. with the rights, throughout the world, an unlimited number of times in perpetuity, to copyright, to use and to license to others in any manner. Owner’s pet(s) may be used in any and all media and in the promotion, advertising, sale, publicizing, etc. of 4- LFDC.

9. General Provisions. Owner expressly agrees that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Michigan, and that this Release shall be governed by and interpreted in accordance with the law of the State of Michigan. Owner agrees that in the event that any clause, portion, or provision of this Release shall be held to be invalid by any court of competent jurisdiction, the remaining clauses, portions, and provisions of this Release shall continue to be enforceable. This Release shall be binding upon the parties and their respective heirs, administrators, personal representatives, executors, successors, assigns, etc. This Release constitutes the entire agreement between the parties and supersedes any prior oral or written agreements or understandings between the parties concerning the subject matters of this Release. This Release may not be altered, amended or modified, except by a written document signed by both authorized parties.

10. Acknowledgment and Certifications. Owner has carefully read and fully understands all the provisions of this Release and is freely, knowingly, and voluntarily entering into this Release. Owner further certifies that Owner’s pet(s) have not harmed or shown aggressive or threatening behavior towards any person or any other animal. Owner’s pet(s) is/are current on the following vaccinations: Distemper, Parvo, Bordetella, and Rabies. Owner shall maintain vaccinations as may be required by 4-LFDC and shall keep 4-LFDC appraised of any updates. Owner certifies that Owner’s pet(s) are in good health and have not been ill with any communicable condition/illness/disease within the last 30 days and will advise 4- LFDC of any new health issues or behavioral issues in the future immediately. 4-LFDC relies upon Owner’s certifications and representations in admitting Owner’s pet(s) to 4-LFDC.

Signature*

Date*

Date

Daycare and Lodging Assessment Request/Enrollment Form

Human's Information

Dog Profile