Day Care Agreement
This form helps us provide the best care for your pet by sharing key details about them. This waiver is valid for one year from enrollment unless revoked in writing. Questions? Email alexandra@kazmak9.com
Owner Information
Owner Name
*
First Name
Last Name
Owner Phone Number
*
Format: (000) 000-0000.
Email Address
*
example@example.com
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact
*
First Name
Last Name
Emergency Contact Phone Number
*
Format: (000) 000-0000.
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Pet Information
Dog's Name
*
Please confirm {dogsName}'s age.
e.g. 4 years old
What breed is {dogsName}?
e.g. Doodle, Aussie, Lab, Chihuahua Mix etc.
What is {dogsName}'s gender?
*
Please Select
Unaltered Female
Spayed Female
Unaltered Male
Neutered Male
Is {dogsName} crate trained?
Please Select
Yes
No (we don't use a crate)
We will only use a crate if that is what your dog is used to.
Please upload {dogsName}'s up to date vaccination records.
Browse Files
Drag and drop files here
Choose a file
We require an up to date DHPP and Rabies vaccine.
Cancel
of
Please share important details about {dogsName} (bad habits, quirky behaviors, where they sleep, any rules you want us to reinforce etc.)
E.g. My dog counter surfs, barks at dogs while on a walk, sleeps in my bed and he is not allowed on our couch.
Please indicate if we will be feeding {dogsName} or administering any medication during their visit.
E.g. Include feeding instructions (time of day etc.)
Do you give permission for photos and/or videos of {dogsName} to be taken during their stay and used for business-related purposes?
Yes, I give permission
No, I do not give permission
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Terms & Conditions
*
I agree to the terms and conditions.
Signature
*
Date Signed
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Print Form
Submit Form
Submit Form
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