Return Client Registration Form

Return Client Registration Form
Customer Details:
First and last name *

First name Last name
Phone Number*
Format: (000) 000-0000.
Dog/Dogs Name *
Does your dog shred bedding ?*
Drop off date*

MonthDayYear
Date
Drop off time *

Sunday thru Friday 9-12 NOON OR 6-7:30PM Saturday 9-12noon only ( Closed Saturday PMs for pick ups/Drop offs )

AM/PM Option
Pick up Date*

MonthDayYear
Date
Pick up time*

Sunday thru Friday 9-12 NOON OR 6-7:30PM Saturday 9-12noon only ( Closed Saturday PMs for pick ups/Drop offs )

AM/PM Option
Has your pet shown any signs of illness such as: Cough, Sneeze,Diarrhea, Vomit, or Running Nose in the last 30 Days?*
Pet Health
My dog climbs fencing*

YesNo
Any suggestions if any for further improvement of our service or business?:
Would you like a groom for your 25lb or under pet?

Full Groom $65+Nails only $15Wash and nails only $45+
How do you feel we have done in in the past ?
For boarding dogs and owners: By signing this contract I am giving my consent for Lupine Kennels and it's owner to take my dog to the vet if deemed necessary by any of aforementioned parties and that I , the owner of the pet(s), agree to pay for any and all such bills. Should my dog bite or cause injury to another dog or person I agree to pay for any and all such bills. Should my dog bite or cause injury to another dog or person I agree to pay for any and all medical or vet expenses. I also agree to pay all costs for damage done to the kenneling facility by my dog. I understand that I am boarding my pet at my own risk and I do not hold Lupine Kennels liable for any illness, injury or death. I the said owner of the pet agree, that the information provided to Lupine Kennels about my pet to the best of my knowledge to be true *
Date*

MonthDayYear
Date
Should be Empty: