Daycare Application

Daycare Application
Name *

First Name Last Name
Email *
example@example.com
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Home Number *

Area Code Phone Number
Cell Number *

Area Code Phone Number
Work Number

Area Code Phone Number
What veterinarian do you go to? *
Veterinarian’s phone number *

Area Code Phone Number
Is there someone else in the home we may contact if needed? *

Yes No
Secondary contact *

First Name Last Name
Secondary contact phone *

Area Code Phone Number
Emergency contact *

First Name Last Name
Emergency phone *

Area Code Phone Number
How many dogs are in need of daycare? *
please answer 1-4
Name of dog #1 *
How long have you had dog #1 *
Where did you get dog #1? *
Sex of dog #1 *

Male Female
Is dog #1 spayed/neutered? *

Yes No
Is dog #1 a rescue? *
What is dog #1’s birthdate? *

Month Day Year
Date
What can you tell us about dog #1’s history? *
What is dog #1’s primary breed? *
What is dog #1’s primary color? *
What is dog #1’s weight in pounds? *
What is dog #1’s energy level? *

Very Low Low Medium High Very High
Is dog #1 crate trained? *

Yes No
Does dog #1 like their crate? *

Yes No
Please tell us what dog #1's interests are. *

Running Playing with balls Playing with toys Jumping Tricks Eating Sleeping
Please select any attributes that accurately represent dog #1’s personality. *

Playful Outgoing Shy Submissive Affectionate Insecure Gentle Quite Mouthy Jumpy Avid Barker Excitable
Please indicate any situations that may result in dog #1 becoming unfriendly or where they may react in a negative manner. *

Grabbing their collar Hugging Being removed from furniture Being touched while sleeping Touching ears Touching paws Touching tail Being pet Removing toy from mouth
Name of dog #2 *
How long have you had dog #2 *
Where did you get dog #2? *
Sex of dog #2 *

Male Female
Is dog #2 spayed/neutered? *

Yes No
Is dog #2 a rescue? *
What is dog #2’s birthdate? *

Month Day Year
Date
What can you tell us about dog #2’s history? *
What is dog #2’s primary breed? *
What is dog #2’s primary color? *
What is dog #2’s weight in pounds? *
What is dog #2’s energy level? *

Very Low Low Medium High Very High
Is dog #2 crate trained? *

Yes No
Does dog #2 like their crate? *

Yes No
Please tell us what dog #2's interests are. *

Running Playing with balls Playing with toys Jumping Tricks Eating Sleeping
Please select any attributes that accurately represent dog #2’s personality. *

Playful Outgoing Shy Submissive Affectionate Insecure Gentle Quite Mouthy Jumpy Avid Barker Excitable
Please indicate any situations that may result in dog #2 becoming unfriendly or where they may react in a negative manner. *

Grabbing their collar Hugging Being removed from furniture Being touched while sleeping Touching ears Touching paws Touching tail Being pet Removing toy from mouth
Name of dog #3 *
How long have you had dog #3 *
Where did you get dog #3? *
Sex of dog #3 *

Male Female
Is dog #3 spayed/neutered? *

Yes No
Is dog #3 a rescue? *
What is dog #3’s birthdate? *

Month Day Year
Date
What can you tell us about dog #3’s history? *
What is dog #3’s primary breed? *
What is dog #3’s primary color? *
What is dog #3’s weight in pounds? *
What is dog #3’s energy level? *

Very Low Low Medium High Very High
Is dog #3 crate trained? *

Yes No
Does dog #3 like their crate? *

Yes No
Please tell us what dog #3's interests are. *

Running Playing with balls Playing with toys Jumping Tricks Eating Sleeping
Please select any attributes that accurately represent dog #3’s personality. *

Playful Outgoing Shy Submissive Affectionate Insecure Gentle Quite Mouthy Jumpy Avid Barker Excitable
Please indicate any situations that may result in dog #3 becoming unfriendly or where they may react in a negative manner. *

Grabbing their collar Hugging Being removed from furniture Being touched while sleeping Touching ears Touching paws Touching tail Being pet Removing toy from mouth
Name of dog #4 *
How long have you had dog #4 *
Where did you get dog #4? *
Sex of dog #4 *

Male Female
Is dog #4 spayed/neutered? *

Yes No
Is dog #4 a rescue? *
What is dog #4’s birthdate? *

Month Day Year
Date
What can you tell us about dog #4’s history? *
What is dog #4’s primary breed? *
What is dog #4’s primary color? *
What is dog #4’s weight in pounds? *
What is dog #4’s energy level? *

Very Low Low Medium High Very High
Is dog #4 crate trained? *

Yes No
Does dog #4 like their crate? *

Yes No
Please tell us what dog #4's interests are. *

Running Playing with balls Playing with toys Jumping Tricks Eating Sleeping
Please select any attributes that accurately represent dog #4’s personality. *

Playful Outgoing Shy Submissive Affectionate Insecure Gentle Quite Mouthy Jumpy Avid Barker Excitable
Please indicate any situations that may result in dog #4 becoming unfriendly or where they may react in a negative manner. *

Grabbing their collar Hugging Being removed from furniture Being touched while sleeping Touching ears Touching paws Touching tail Being pet Removing toy from mouth
Have any of your dogs ever climbed a fence? *

Yes No
Have any of your dogs gone to daycare before? If yes, please explain. *
Have any of your dogs ever bitten a person? If yes, please describe. *
Have any of your dogs ever bitten another dog? If yes, please describe. *
Do any of your dogs guard resources (ie. food, toys,treats,or people)? If yes, please describe. *
Are any of your dogs sensitive to noise? Please explain *
Do your dogs like children? Please explain. *
Do any of your dogs have any health issue? Please explain. *
Do any of your dogs have any allergies? Please describe the allergy and your dog’s reaction. *
Do any of your dogs have any dietary restrictions? *
Do any of your dogs go to dog parks? *

Yes No
Have any of your dogs ever exhibited aggressive behavior towards other dog/people are the park such as mouthing, teething, fighting, or raising hackles? *
What do your dogs do when you are not at home? *
Are there any people your dog(s) dislike or fear? *
How do your dogs react to small dogs or puppies? *
Have any of your dogs ever growled or snapped at anyone who has tried to take food or toys away? *
Special instructions or other information we should know about *
Do you mind if your dog gets wet or plays in a dog pool? *
Do you mind if we give your dog a bath if needed? *

When would you like to bring your dog(s). Due to the pandemic we are only open three days a week at this time. *

	Tuesday	Wednesday	Thursday
Full day
Half day

How did you hear about us? *
Please upload a picture of your dog.

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