Daycare Boarding Application

Daycare & Boarding Application

(please complete a separate application for each dog)

How did you hear about us? Internet search referral driving by flyer etc.

Owner: Include all owners of pet

Cell Phone #1

Cell Phone #2

Emergency Contact

Emergency Contact Phone

Owner E-Mail Address

Owner Home Address

Street Address Line 2

CityState

Zip Code

Names of people authorized to drop offpick up your dog

Dog Name

Color

Breed

Male or Female? (Must be neutered or spayed at 6 months of age)

Weight

Date of Birth

Date

Distinctive Markings/Features Veterinarian

Distinctive MarkingsFeatures

Veterinarian

Phone

Immunization Requirements: It is the responsibility of the Owner to provide proof of vaccination in writing or by email/fax from their veterinarian for each animal attending Playful Pooch. Dogs whose shots are not current will not be allowed to attend. The following vaccinations must have been administered prior to attendance:

* Distemper (DHLPP or DA2PP)

* Rabies

* Bordetella

*OWNER UNDERSTANDS THAT EVEN IF OWNER'S DOG IS VACCINATED AGAINST BORDETELLA, THERE IS A CHANCE THAT THE OWNER'S DOG(S) MAY STILL CONTRACT THE ILLNESS. OWNER AGREES TO HOLD PLAYFUL POOCH HARMLESS IF THIS SHOULD OCCUR.

Current Medical Conditions

Medications and Dosage

Feeding Instructions: Please bring your own dog food in re-sealable bags or containers. Keeping your dog on its current diet will minimize stomach distress. It is not necessary to bring bowls. (We do not allow indigestible rawhide or hard or brittle treats of any kind)

Food Brand

Quantity

Is our food ok in case of emergency!

Food Restrictions

Food Allergies

General Questions - Please keep in mind that ALL dogs must be socialized and able to participate in group play:

How long have you had your dog

If adopted, do you have any knowledge of your dogs past social history?

Has your dog ever been to daycare?

If so when was the last time?

What facility

Any kennel stress

Why are you looking for daycare or boarding?

Describe your dogs play style

How many friends does your dog have that he/she plays with regularly?

Does your dog bark a lot? Playful barking is fine, but continuous, habitual barking during the rest periods is not allowed. Quality rest is important during the mid-day break and at night for the overall health of our guests.

What does your dog do when he/she gets upset?

Has your dog ever bitten anyone? If so, please describe the circumstances.

Has your dog ever jumped a 5 foot high fence?

Please list any other information about your dog that may be helpful to us:

Please Note: We provide pet cots as long as your dog is not a chewer. We ask that you not bring dog beds, blankets or toys. Owner understands that the staff of Playful Pooch is relying on the above information when providing daycare and/or boarding services to their dog. In the event that any of the information provided proves to be inaccurate regarding the behavior of the Owner's Dog(s) and results in injury to the dog, other dogs, staff, or physical property of Playful Pooch, Owner will be responsible for any costs incurred.

Owner Name Please Print

Owner Signature

Date