DOGUE Country Retreat - Expression of Interest

DOGUE Country Retreat - New Guest(s) Details and Registration Form Welcome to DOGUE Country Retreat, Boutique Hotel & Day Spa for Dogs. As you have not had the luxury of staying with us before we ask you to complete the following questions to help us understand more about your needs and requirements. **Please make sure you have completed the Initial Enquiry Form first - you will then be advised whether to complete this form.**

Please keep in mind that DOGUE Country Retreat is a small and intimate haven, we hope you understand that we are not able to cater for all sizes, personality and breed of guest. We focus on small to medium sized guests under 15kg especially at peak times during the year.

Once you have completed this form we will be in touch regarding your stay at the DOGUE Country Retreat. If you need to make a last minute booking please call the Retreat directly at (02) 4877 1877.

Please refer: to the Terms and Conditions and Pricing on the Retreat web page.

Please note: Christmas, School Holiday and Easter bookings require a 50% non-refundable deposit that will be deducted from the accommodation cost. All other bookings require a 10% non-refundable deposit.

Christmas, Easter and School Holidays - minimum weekly i.e. 5 day stay / bookings

Full payment is required for accommodation stay before check-in and can be paid by cash, eftpos or credit card. Extra charges incurred during the stay will be paid at check-out.

We will send you a separate email regarding payment.

We look forward to taking exceptional care of your canine family members in your absence.

Best Regards,

Lemmy

Guest Relations Manager

DOGUE Country Retreat
Guest Name(s):
Please provide canine(s) first and last names*
I / we would like to stay:
Check-in*

DayMonthYear
Date
Check-out*

DayMonthYear
Date
Total number of days (Please include check-in and check-out days.)*
Please confirm daily rate (if quoted)
Please advise if you require transport to or from the Retreat

Transport from Bondi to the RetreatTransport from the Retreat to Bondi
My main human's contact details are:
Name*

First NameLast Name
Email*
Mobile*
Phone number
Address*

Street Address

Street Address (optional)

SuburbState / Province

Postal / Zip CodeCountry
My second human's contact details are:
Name*

First NameLast Name
Relationship to my main human*
eg. Spouse, Sibling, Parent, Friend, Neighbour, etc
Email*
Phone number*
My Veterinary Clinic's Details:
Guest(s) Regular Veterinary Clinic / Hospital*
Veterinarian Address*
Veterinarian Telephone*
Veterinarian Email
myvet@example.com
Contacting your human during your stay:
Best way to contact your human*

TextMobileEmailHotelSkypeFacebookInstagram
Specify Hotel or other specific contact details*
Specify Skype Details*
Specify Instagram name*
Specify Facebook name*
My human is travelling:
Travelling*

Within NSW / ACTWithin QLD / VICWithin NT / WA / SA / TASInternationally
Emergency Contact (in Australia)
Name*

First NameLast Name
Phone number*
Email address*
Relationship to my main human*
eg. Spouse, Sibling, Parent, Friend, Neighbour, etc
GUEST(S) DETAILS
Please fill out a little more about yourself and/or other guests who would like to stay at DOGUE Country Retreat (one per guest please)
How many guests including yourself?*
GUEST ONE
Guest Name*
Guest Breed or Cross Breed*
Guest Date of Birth*

DayMonthYear
Date
Guest Age*
Guest Weight*
PLEASE NOTE: we can only accommodate guests 15kg and under.
Guest Height*
Guest Gender*

MaleFemale
Guest is desexed / neutured?*

YesNoNot sure
Microchip Number*
Please check the boxes below as they apply to you
PERSONALITY
How would you describe yourself (tick all that apply)*

ConfidentFearfulDominantSubmissiveBoisterousPlayful
SOCIABILITY
How social are you*

I LOVE to play with other dogs - I'm super playful!!!I sometimes like to play with other dogsI don't play, but I'm happy to be around other dogs!Not comfortable at all with other dogs
Please detail
SLEEPING
Where do you normally sleep*

Outside and/or in a kennelOn your own bedOn your human's bedIn a crate
TRAINING BACKGROUND
Have you attended puppy school*

YesNo
Have you attended any form of obedience training*

YesNo
How did you go with training*

PassFailN/A
What basic instructions do you follow?*

ComeSitStayOthers (please specify below)
Please specify Others
Do you walk well on a lead?*
Are you good at recall (off lead)?*
Do you respond to treats?*
TOILET TRAINING
I am ...*

Not housebroken and can have accidentsUsing puppy (potty) padsTrained to go outside
AWAY FROM HOME EXPERIENCE
Have attended day care before?*

YesNo
Where did you go? Did you enjoy day care experience? Please expand
Have attended a boarding facility or home before?*

YesNo
Where did you go? Did you enjoy your boarding experience? Please expand
BARKING
I bark when ...*

I want attentionI am left aloneI am in a crate or kennelSometimes for no reason at allI get excited or I am playingRarely, if ever
CHEWING
I chew ...*

On anything within reach!Only on my own toysOn my bedTo get out of things, including fencing!I am not a chewer
AGGRESSION
I can be aggressive ...*

Around foodWith my toys (play growling not included!)Other dogsAround strangersAround menAround childrenIn my area/territorialWhen I am fearfulWhen I"m picked upNever
Please answer the following questions and provide any details...
Have you ever bitten a person or another dog?*

YesNo
Please provide details
Have you ever been attacked by another dog?*

YesNo
Please provide details
Do you jump or climb fences?*

YesNo
Please provide details
Do you like to dig your way out?*

YesNo
Please provide details
Please provide details if you experience any of the following...
Separation anxiety
Fear of loud noises such as thunder or fireworks
Particular parts of your body that you don’t like to have touched. Please state which areas
Anything else you would like us to know regarding your behaviour ?
VACCINATION AND PARASITE PREVENTION DETAILS
Date of last Canine C3 or DHP Vaccination*

DayMonthYear
Date
Date of last Canine Cough or KC Vaccination*

DayMonthYear
Date
(Please email a photo or copy of your C5 vaccination certificate or equivalent C5 vet certification to retreat@dogue.com.au)
Please specify type and date of flea/tick product last applied*
Date next flea/tick product due*

DayMonthYear
Date
Supplied by owner?

YesNo
Please specify type and date of next due heartworm treatment*
Supplied by owner?

YesNo
(Flea & tick treatment and vaccinations must be up to date prior to arrival. Additional treatments provided by DOGUE Country Retreat will be at carer"s cost)
MEDICATION DETAILS
Medication / Treatment required*

YesNo
Please list each medication, what it is used to treat, the dosage, how many times to administer daily, and how you administer it? (eg in a piece of cheese, etc.)
Does your dog have any current health problems, allergies or past injuries?*

YesNo
Please Detail
DINING DETAILS
What would you like to dine on during your stay? (Please refer to Dining Menu on our website. Some options will incur additional charges.)*

Retreat's Man's Best Lamb grain-free kibble, with homemade chicken and veg broth topper (no extra charge)BYO: Carer's own selection of food (additional $10 per day)Other - please specify in box below
Please advise how often you eat and what is your portion size. Provide any other information regarding eating or treats.*
Is there anything else you would like us to know ? Please Detail
GUEST TWO
Guest Name*
Guest Breed or Cross Breed*
Guest Date of Birth*

DayMonthYear
Date
Guest Age*
Guest Weight*
PLEASE NOTE: we can only accommodate guests 15kg and under.
Guest Height*
Guest Gender*

MaleFemale
Guest is desexed / neutured?*

YesNoNot Sure
Microchip Number*
Please check the boxes below as they apply to you
PERSONALITY
How would you describe yourself (tick all that apply)*

ConfidentFearfulDominantSubmissivePlayfulBoisterous
SOCIABILITY
How social are you*

I like to play with other dogs - YESI like to play with other dogs - NOI like to play with other dogs - SOMETIMESNot comfortable at all with other dogs
SLEEPING
Where do you normally sleep*

Outside and/or in kennelOn your own bedOn your humans bedIn a crate
TRAINING BACKGROUND
Have you attended puppy school*

YesNo
Have you attended any form of obedience training*

YesNo
How did you go with training*

PassFail
What basic instructions do you follow?*

ComeSitStayOthers (please specify below)
Please Specify
Do you walk well on a lead?*
Are you good at recall (off lead)?*
Do you respond to treats?*
TOILET TRAINING
I am ...*

Not housebroken and have accidentsTrained to go outsideUsing puppy (potty) pads
AWAY FROM HOME EXPERIENCE
Attended day care before*

YesNo
Attended a boarding facility or home before*

YesNo
Did you enjoy your boarding or day care experience ? Please expand
BARKING
I bark when ...*

I want attentionI am left aloneI am in a crate or kennelSometimes for no reason at allI get excited or I am playingRarely, if ever
CHEWING
I chew ...*

On anything within reach!Only on my own toysOn my bedTo get out of things, including fencing!I am not a chewer
AGGRESSION
I can be aggressive ...*

Around foodOther dogsAround strangersAround childrenIn my area/territorialWhen I am fearfulWhen I"m picked upNever
Please answer the following questions and provide any details...
Have you ever bitten a person or another dog*

YesNo
Please provide details
Have you ever been attacked by another dog*

YesNo
Please provide details
Do you jump or climb fences*

YesNo
Please provide details
Do you like to dig your way out*

YesNo
Please provide details
Please provide details if you experience any of the following...
Separation anxiety
Fear of loud noises such as thunder or fireworks
Particular parts of your body that you don’t like to have touched. Please state which areas
Anything else you would like us to know regarding your behaviour?
VACCINATION AND PARASITE PREVENTION DETAILS
Date of last Canine C3 or DHP Vaccination*

DayMonthYear
Date
Date of last Canine Cough or KC VaccinationDate of last Canine Cough Vaccine*

DayMonthYear
Date
(Please email a photo or copy of your C5 vaccination certificate or equivalent C5 vet certification to retreat@dogue.com.au)
Please specify type and date of flea/tick product last applied*
Date next flea/tick product due*

DayMonthYear
Date
Supplied by owner?

YesNo
Please specify type and date of next due heartworm treatment*
Supplied by owner?

YesNo
(Flea & tick treatment and vaccinations must be up to date prior to arrival. Additional treatments provided by DOGUE Country Retreat will be at carer"s cost)
MEDICATION DETAILS
Additional Medication*

YesNo
Please list each medication, what it is used to treat, the dosage, how many times to administer daily, and how you administer it? ( eg in a piece of cheese, etc.)
Do you have any current health problems, allergies or past injuries?*

YesNo
Please Detail
DINING DETAILS
What would you like to dine on during your stay ? (Please refer to our Dining Menu on our website. Some options will incur additional charges.)*

Retreat's Man's Best Lamb grain-free kibble, with homemade chicken and veg broth topper (no extra charge)BYO: Carer's own selection of food (additional $10 per day)Other - please specify in space below
Please advise how often you eat at home and what is your portion size? Please provide any other information about eating or treats.*
Is there anything else you would like us to know? Please Detail
GUEST THREE
Guest Name*
Guest Breed or Cross Breed*
Guest Birthday*

DayMonthYear
Date
Guest age*
Guest height*
Guest weight*
PLEASE NOTE: we can only accommodate guests 15kg and under.
Guest gender*

MaleFemale
Guest is desexed / neutured?*

YesNoNot Sure
Microchip Number*
Please check the boxes below as they apply to you
PERSONALITY
How would you describe yourself (tick all that apply)*

ConfidentFearfulDominantSubmissivePlayfulBoisterous
SOCIABILITY
How social are you*

I like to play with other dogs - YESI like to play with other dogs - NOI like to play with other dogs - SOMETIMESNot comfortable at all with other dogs
SLEEPING
Where do you normally sleep*

Outside and/or in kennelOn your bedOn your humans bedIn a crate
TRAINING BACKGROUND
Have you attended puppy school*

YesNo
Have you attended any form of obedience training*

YesNo
How did you go with training*

PassFailN/A
What basic instructions do you follow?*

ComeSitStayOthers (please specify below)
Please Specify
Do you walk well on a lead?*
Are you good at recall (off lead)?*
Do you respond to treats?*
TOILET TRAINING
I am ...*

Not housebroken and have accidentsI am trained to go outsideUsing puppy (potty) pads
AWAY FROM HOME EXPERIENCE
Attended day care before*

YesNo
Attended a boarding facility or home before*

YesNo
Did you enjoy your boarding or daycare experience ? Please expand
BARKING
I bark when ...*

I want attentionI am left aloneI am in a crate or kennelSometimes for no reason at allI get excited or I am playingRarely, if ever
CHEWING
I chew ...*

On anything within reach!Only on my own toysOn my bedTo get out of things, including fencing!I am not a chewer
AGGRESSION
I can be aggressive ...*

Around foodOther dogsAround strangersAround childrenIn my area/territorialWhen I am fearfulWhen I"m picked upNever
Please answer the following questions and provide any details...
Have you ever bitten a person or another dog*

YesNo
Please provide details
Have you ever been attacked by another dog*

YesNo
Please provide details
Do you jump or climb fences*

YesNo
Please provide details
Do you like to dig your way out*

YesNo
Please provide details
Please provide details if you have any of the following...
Separation anxiety
Fear of loud noises such as thunder or fireworks
Particular parts of your body that you don’t like to have touched. Please state which areas
Is there anything else you would like us to know with regards to your behaviour?
VACCINATION, MEDICATION AND DINING DETAILS
Date of last Canine C3 or DHP Vaccination*

DayMonthYear
Date
Date of last Canine Cough or KC VaccinationDate of last Canine Cough Vaccine*

DayMonthYear
Date
(Please email a photo or copy of your C5 vaccination certificate or equivalent C5 vet certification to retreat@dogue.com.au)
Please specify type and date of flea/tick product last applied*
Date next flea/tick product due*

DayMonthYear
Date
Supplied by owner?

YesNo
Please specify type and date of next due heartworm treatment*
Supplied by owner?

YesNo
(Flea & tick treatment and vaccinations must be up to date prior to arrival. Additional treatments provided by DOGUE Country Retreat will be at carer"s cost)
Additional Medication*

YesNo
Please list each medication, what it is used to treat, the dosage, how many times to administer daily, and how you give it to the dog (in a piece of cheese, etc.)
Does your dog have any current health problems, allergies or past injuries?*

YesNo
Please Detail
DINING DETAILS
What would you like to dine on during your stay? (Please refer to Dining Menu on our website. Some options will incur additional charges.)*

Retreat's Man's Best Lamb grain-free kibble, with homemade chicken and veg broth topper (no extra charge)BYO: Carer's own selection of food (additional $10 per day)Other - please specify in box below
Please advise how often you eat and what is your portion size. Provide any other information regarding eating or treats.*
Is there anything else you would like us to know ? Please Detail
EXTRA PAMPERING AVAILABLE
At DOGUE Country Retreat we also offer a range of specialised services to suit every guest's needs including weight loss programs, nutritional advice and, of course, extra pampering in the day spa.

A grooming appointment is always a lovely way to end a holiday at the Retreat and to go home feeling fresh and looking your best!
Additional Services*

Wash and Blow Dry (including a nail trim)Wash and Tidy (tidy face, feet & hygiene area and including a nail trim)Wash and Body Clip (including a nail trim)Nutrition / Weight Loss ProgramNo Additional Services Needed
Please specify condition of coat and style of clip you would like such as Teddy Bear, Breed Specific with a Skirt, etc. We need to know length and shape. Also, if we haven't groomed them before, please send a photo of them freshly groomed so we can see your preference (retreat@dogue.com.au). Thank you!*
My regular groomer / grooming salon is*
In case more intricate grooming details are needed
Are you a regular client of any DOGUE stores or the Retreat? Please specify which store and on what basis?
Which store(s)

AvalonBalmainBondiCremorneGungahlinGymeaRetreatWahroongaZetland
Which of these are you ...

Regular Grooming CustomerRegular Day Care CustomerIn-Store Retail CustomerOnline Retail Customer
If you are not a regular attendee to grooming or day care, we may organise a time for you come in for a behavioural assessment – this will cost the equivalent of a half day in day care ($25).
How did you hear about the DOGUE Country Retreat?*

GoogleYellow/white pagesFacebookInstagramDOGUE StorePersonal recommendationMagazine/newspaperOther
Please let us know who recommended us:

First NameLast Name
TERMS AND CONDITIONS OF STAYING AT DOGUE COUNTRY RETREAT
Check-in: 9:00am – 11:00am and Check-out: 2.00pm – 4:00pm, 6 days a week.

During peak holidays and public holidays these do change.

Please note: the term “carer” refers to the person responsible for making decisions and making all payments for the duration of the guests stay. The term “guest” refers to all the carer’s dog(s) staying At the DOGUE Country Retreat.
GENERAL TERMS:

DOGUE Country Retreat will exercise reasonable care for the safety of your dog(s) and to keep the boarding premises safe and secure. Carer is solely responsible for any property damage or bodily injury inflicted by your dog(s). DOGUE Country Retreat cannot guarantee against accidents. We will not be liable for loss or damages to dog(s) belongings.
I have read the above statements, and*

I AGREEI DON'T
BOARDING REQUIREMENTS:

Guest(s) are to check in with a standard collar including ID tag in addition to harnesses or other walking gear. Carers are to provide usual food and treats unless selecting from DOGUE Country Retreat menu. Dry food is best in large, labelled zip-lock bags. If dog(s) are trained to use training pads, these are to be provided by carer. Carers may also bring treats, toys and bedding such as blankets. Label all items brought in the dog’s name. PLEASE do not bring any guest(s) feeding dishes and large bedding items.
I have read the above statements, and*

I AGREEI DON'T
VACCINATIONS/HEALTH: All guest(s) must be current on C5 vaccination including kennel cough or have certification on their immunity levels from their vet such as a titer test. The carer must provide to DOGUE Country Retreat the veterinarian records on paper for these vaccines at least 48 hours prior to check-in. All guests accepted for accommodation must be of free of fleas and ticks and up to date on their flea and tick treatments
I have read the above statements, and*

I AGREEI DON'T
FLEA OR PARASITE TREATMENT: All guests accepted for accomodation must be free of fleas and ticks and up to date on their flea and tick treatments. If fleas, worms or other parasites are found on a guest, DOGUE Country Retreat is authorised to apply the appropriate treatment for the guest(s) and charge me as the carer accordingly, and I agree that such charge will be payable on the guests departure from DOGUE Country Retreat.
I have read the above statements, and*

I AGREEI DON'T
DESEXING:

All guests are to be desexed over the age of 6 months to board at DOGUE Country Retreat. A Desexing certificate is to be emailed to retreat@dogue.com.au, prior to the guest arriving for their stay. Male guests that have a male contraceptive chip will be allowed, given that we have an up-to-date certificate. Guests under 6 months can board, given that females have not had their first heat and that males are not yet showing signs of sexual maturity.
I have read the above statements, and*

I AGREEI DON'T
MEDICATION & TREATMENT AUTHORIZATION AND VETERINARY CARE : Prescription medications must be provided in the original container with the veterinarian’s Instructions, it will be administered as prescribed by our trained staff. Over-the-counter meds, such as worming or flea/tick treatments, may be given if necessary. DOGUE Country Retreat is authorized by the owner to seek veterinary advice and care, including but not limited to emergency care, at their discretion and at the carer’s sole expense. DOGUE Country Retreat will attempt to contact the carer before obtaining this care if possible, but this document serves as full authorization to obtain veterinary care for the pet at the carer’s expense, whether or not carer has been contacted.
I have read the above statements, and*

I AGREEI DON'T
ELDERLY GUESTS:

Carers of elderly guests (approaching the end of life) need to know if in the event Carer’s guest passes on while in our care, our policy is to transport Carer’s guest to Carer’s vet where he/she will be held until Carer can be reached by the Vet for further instructions. If Carer’s vet is closed or outside of our transport distance, then we will transport to nearest 24-hour facility. Trip charge will apply based on time/distance.
I have read the above statements, and*

I AGREEI DON'T
WEAKENED IMMUNE SYSTEM

Carer understands special-needs guests, young puppies and senior guest naturally have a higher risk of injury, stress-related illnesses, weakened immune systems, or exacerbation of any pre-existing condition, As such, by using our facility for daycare or boarding the carer is waiving any claim for injury or illness experienced by guest while in our care.
I have read the above statements, and*

I AGREEI DON'T
ILLNESS OR INJURY: DOGUE Country Retreat shall not be held responsible for Canine Influenza, Paralysis Tick or any injury that may occur to a guest during their stay at DOGUE Country Retreat. Carer"s need to be aware that the Retreat is on a rural property and while the utmost care is taken by all staff and daily health checks are carried out, there is an increased possibility of snake bites, spider bites, other insect bites and grass seed infections than experienced in urban areas.
I have read the above statements, and*

I AGREEI DON'T
TRANSPORT AND OTHER ACTIVITIES AWAY FROM RETREAT DOGUE Country Retreat will exercise reasonable care for the transport of all guests when to and from the Retreat, using safety seat belts and/or crates for safe transportation. DOGUE Country Retreat cannot guarantee against accidents or injury during transportation or any other activities away from the Retreat.
I have read the above statements, and*

I AGREEI DON'T
FIRE AND OTHER NATURAL EVENTS: DOGUE Country Retreat is located in a rural setting and while is not considered a high risk fire area, during times of severe heat, wind, thunderstorms and/or drought, the fire risk is greatly increased. DOGUE Country Retreat has a thorough fire and evacuation plan in place, and has installed fire fighting equipment at the Retreat. All staff are trained in responding to fire situations and evacuating guests. DOGUE Country Retreat can not be responsible for injury to a guest or loss of life due to fire or other natural events.
I have read the above statements, and*

I AGREEI DON'T
ABANDONED GUESTS: DOGUE Country Retreat will go to great lengths to reunite and avoid having guests left behind after their stay. If such circumstances arise, DOGUE is authorised to rehouse or make whatever other arrangements that are considered appropriate for a canine guest if it has not been collected within 14 days of the date on which it was due to depart and despite our best efforts, there has been no contact made by the carer or carer’s family. This will be solely in DOGUE Country Retreat’s discretion.
I have read the above statements, and*

I AGREEI DON'T
PAYMENT TERMS:

Carer agrees to pay quoted deposit in advance to secure their reservation and full accommodation price prior to check-in or at check-in. Boarding credit (valid for 6 months from issue) will be issued for cancellations with 14 days’ notice only, except for holidays and peak season. Early departures will not be refunded.
I have read the above statements, and*

I AGREEI DON'T
Canine guests shall not leave DOGUE Country Retreat until all fees owing to DOGUE Country Retreat have been paid in full.

Once we have received your booking and processed it, we'll send a confirmation email. Please check the details carefully and let us know if you have any questions.

DEPOSITS:

10% non-refundable deposit is required for all off-peak bookings. 50% non-refundable deposit is required for all peak bookings which include public holidays and school holidays. Guests are fully registered once their deposit is received.

Payment can be made via cheque, cash, credit card, eftpos or direct transfer to:

Account Name: DOGUE Retail
BSB: 082 140
Account Number: 58 375 8701

Please put Guest's name in payment reference details and send a payment confirmation receipt through to retreat@dogue.com.au
By checking the box below, placing your name as requested & submitting this document, you are bound by the declaration below
I have read, understand and agree to the terms of guest accommodation at DOGUE Country Retreat.*

true
Todays Date*

DayMonthYear
Date
Your Full Name*
Signature (to be filled out at check-in)
Thank you so much for taking the time to complete this form, it helps us to assess your suitability for DOGUE Country Retreat and to be able to tailor your stay to your requirements. We will be in touch with further information very soon.
Should be Empty: