Registration Form

Registration Form

Pet(s) Information Form
Name*

First NameLast Name
Name (Optional)

First NameLast Name
Mobile Number*
Please enter a valid phone number.
Mobile Number
Please enter a valid phone number.
Email*
example@example.com
Email
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

EMERGENCY INFORMATION [CLICK HERE]
I hereby designate the following person(s) to take physical possession of my pet(s) in the event of an emergency, or my incapacity or my death: **PLEASE DO NOT PUT YOURSELVES HERE, EVEN IF YOUR CONTACTS ARE LOCATED OUT OF TOWN, PLEASE PUT DOWN 1 CONTACTS.
Primary Emergency Person:*

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

First NameLast Name
Phone Number
Please enter a valid phone number.

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How did you hear about Packlife Boarding and Daycare, LLC?
ex: Google, friend, Facebook...
If referred by a friend, please tell us who so we can thank them:
Full Name Please
All dogs are required to have proof of rabies (including DDHP and Bordetella). Please provide copy of UpToDate Vaccinations.
Vaccine Upload

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PET(S) DETAILS*

TRAITS: Please answer the following brief questionnaire about your pet. It will help us to better care for him/her. [CLICK HERE]
For each pet*

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	Do you have specific words for the following:
Feeding
Potty
Treats
Bedtime

Medication: Is your pet on any medications that must be administered? If yes, please describe the medication procedures including name, dosage:

Advanced Directive (Rainbow Bridge) Protocol [CLICK HERE]
Pet's Name*
Packlife Boarding & Daycare, LLC policy is to have an Advanced Directive or Rainbow Bridge Protocol for senior and/or pets with a medical or physical condition that could be life threatening. This is a precautionary measure to guide us in following your wishes if your pet passes away while in our care.
Please check off your wishes below:*

I want my emergency contact to be called to pick up and assume responsibility for my pet. However, if my emergency contact is unreachable or unavailable, I understand that Packlife Boarding & Daycare, LLC will transport my pet to a veterinarian or crematorium and the expenses will added to my invoice and payable to Packlife Boarding & Daycare, LLC (Owner).I authorize Packlife Boarding & Daycare, LLC to transport my pet to a veterinarian’s office or crematorium for cremation and I wish to have my pet’s ashes returned. This would be a private cremation.I authorize Packlife Boarding & Daycare, LLC to transport my pet for cremation but I do NOT wish to have my ashes returned. This would be a group cremation.I do NOT wish to have my pet cremated and would prefer to have my pet returned to me for a private burial. Your pet will be kept at an appropriate facility until your return and your pick up.Do you want us to contact you in the event your dog passes away while in our care? If yes, please give us your best contact information to reach you for this trip: (below-1A)If my pet is found deceased, I would prefer to wait to learn about it upon my return. Emergency contact’s name & contact information: (below-1B)
1A
1B
Veterinary or Designated Facility:
By signing below, I understand that costs may be incurred for transportation, cremation and/or storage of my pet. I give Packlife Boarding & Daycare, LLC permission to follow through with my wishes as stated above and I agree to make any payment due upon my return.
Initials*
Printed Name:
Date*

MonthDayYear
Date

Consent of use of Images/Video [CLICK HERE]
Initials*

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Like & Follow to keep Up-To-Date with Packlife Boarding and Daycare, LLC!!
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Registration Form

All dogs are required to have proof of rabies (including DDHP and Bordetella). Please provide copy of UpToDate Vaccinations.