Registration Form: Doggie Daycare & Boarding
Pet Owner's Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Emergency Contact #1
*
First Name
Last Name
Emergency Contact #1 Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact #2
First Name
Last Name
Emergency Contact #2 Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Veterinarian
*
Veterinarian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Who else is authorized to pick up your dog?
*
How did you hear about us?
Or Referred by?
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Pet's Name
*
Breed
*
Age
*
Gender
*
Male
Female
Weight
*
Color
*
Spayed/Neutered?
*
Yes
No
Food Name and Feeding Instructions
*
Medications
*
Allergies
*
Describe any medical conditions
*
How long has your dog been in your family?
*
House Trained?
*
Yes
No
Does your dog get along with other dogs?
*
Yes
No
Ever bitten another dog or person?
*
Yes
No
Does your dog growl or snap when food or toys are taken away?
*
Is your dog a chewer or does it have oral fixation? (chews blankets, etc.)
*
Yes
No
Has your dog previously boarded?
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Yes
No
How does your dog behave at the facility?
*
How does your dog behave in public?
*
Has your dog ever had professional training?
*
Yes
No
If so, where?
Fears? (Thunderstorms, etc.)
*
Barks excessively?
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Yes
No
Has your dog ever climbed/jumped a fence?
*
Yes
No
Is your dog a digger?
*
Yes
No
Any behavioral problems?
*
Yes
No
Explain
Please attach a copy of your dog's current vaccinations
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I understand Kobi’s Kennels / Rocky Top K9, LLC may use my pictures of me or my dog for publicity or promotional purposes for Kobi’s Kennels / Rocky Top K9, LLC without obligation or liability of any kind to me. Personal information will never be shared or sold. I further understand that while Kobi’s Kennels / Rocky Top K9, LLC will do everything possible to keep my dog safe, but in the event of an emergency, I give permission for my dog to be seen / treated at a local veterinarian’s office. I understand that there can be unforeseen circumstances that can occur, that there is a minimal risk of injury or death to my dog, and I hold Kobi’s Kennels / Rocky Top K9, LLC harmless in case of such injury or death.
*
I Agree
Signature
*
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