CHICAGO PUPS APPLICATION & WAIVER

I understand that I am solely responsible for any harm caused by my dog(s) while my dog(s) is/are attending daycare at Chicago Pups.

I also understand and agree that in admitting my dog(s), Chicago Pups 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 Chicago Pups, if I am unreachable in the event of an emergency, I hereby authorize Chicago Pups, 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, Chicago Pups, 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 Chicago Pups 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. Chicago Pups reserves the right to permanently remove a dog from daycare at any time. In addition, Chicago Pups reserves the right to disallow certain breeds to participate in the daycare.

DOG(S) NAME(S)

SIGNATURE OF OWNER

DATE

Date

PRINT NAME OF OWNER

CHICAGO PUPS REPRESENTITIVE

1. Name

2. Address

3. City

Zip Code

4. Phone

5. Evening Phone

6. Emergency Contact

7. E Mail Address

example@example.com

1. Name

2. Breed

3. Sex F or M

Spayed/Neutered Y or N

4. Weight of Dog

5. Brand(s) of Food Dog Eats

6. Birthday/Age

7. Vet Name

8. Vet Address

Please upload vaccination records*

Vet Phone Number 9.

10. Has your dog been to any dog parks? If so, how did they play and interact with the other dog(s)?

11. Has your dog ever attempted to bite another dog or person? If yes, please explain.

12. Is your dog toy or food possessive? If yes, please explain.

13. Has your dog ever been in a fight with another dog? If yes, please explain.

14. Any medical conditions we need to know regarding your dog?

15. Please list any meds and/or feeding times you want us to follow.

16. Has your dog been to any obedience classes? If so, what classes and where?

17. Does your dog have any problems with dogs smaller or larger than they are?

18. Chicago Pups will be picking up and dropping off your dog on most occasions. Do you have any special requests? i.e. alarm code set or disarm, heat/ac, television, etc.

19. Please tell us how you heard about us.

20. Please indicate days interested in for daycare:

Interested days

DOG DAYCARE & WAIVER FORM

Dog Information