BoardingRegistration

Drop Off Date: Enter Drop Off Date: / Drop Off Time: Enter Drop Off Time:
Pick Up Date: Enter Pick Up Date: / Approx. Pick Up Time: Enter Pick Up Time:

Pickup time can be any time during business hours. If you pick up before 12:00PM there is no charge for the day. You are welcome to pick up after 12:00PM, however there is a charge of $3.00/hour/dog for every hour after 12:00PM.

PRICING

1st Dog - $30.0/Day2nd Dog - $28.00/Day3rd Dog - $26.00/Day

PET PARENT INFORMATION

Pet Parent(s) Name(s): Enter Name(s):
Email Address: Enter Email Address:
Phone (1):Enter Phone (1): / Phone (2): Enter Phone (2):
Street Address, City, and Postal Code: Enter Address:
Credit Card Information All Boarding Reservations require a CC to be on file.
Card Type: Visa ☐ MasterCard ☐ American Express ☐
Card Number: Enter Card Number
Expiry Date: MM / YY

EMERGENCY CONTACT INFORMATION

In the event that you cannot be reached, who may be contact regarding your pet?

Emergency Contact Name(s): Enter Name(s):
Phone (1):Enter Phone (1): / Phone (2): Enter Phone (2):

HOW DID YOU HEAR ABOUT US?

If you were referred to us please provide us with a referral name for our Customer Referral Program:
Referral Name:

GUEST INFORMATION

Pet Name: Enter Pet Name / Date of Birth: Enter Pet DOB
Sex: / Male ☐ / Female ☐ / Spayed or Neutered: / Yes ☐ / No ☐
Breed: Enter Breed / Colour: Enter Colour
If FEMALE and not spayed when was her last heat cycle: Enter Last Heat Cycle
Would you like her in daycare? If yes, you accept the possibility she may be bred by another dog if she is in heat, silent heat, recently out of heat or if her heat cycle is not known. / Yes ☐ / No☐
Veterinary Clinic Name: Enter Veterinary Clinic:
Phone: Enter Veterinary Phone:

GUEST HEALTH INFORMATION

Does your pet have any allergies? / Yes ☐ / No ☐
If Yes, Please List:
Does your pet have any health concerns that require special attention? / Yes ☐ / No ☐
If Yes, Please List:
Do you have anything else you would like to tell us about your dog? / Yes ☐ / No ☐
If Yes, Please List:
Does your pet require medication? / Yes ☐ / No ☐
All medications must be in original container, clearly labeled with pets name and dosage requirements. Please not there is an additional charge for administering medications. Pills and Liquids are $2.00/dose and injections are $3.00/dose.
If yes, please list:
Pill / Liquid / Injection / Medication Name / Dose / AM / Noon / PM
☐ / ☐ / ☐ / Enter Medication Name: / Enter Dose: / ☐ / ☐ / ☐ /
☐ / ☐ / ☐ / Enter Medication Name: / Enter Dose: / ☐ / ☐ / ☐ /
☐ / ☐ / ☐ / Enter Medication Name: / Enter Dose: / ☐ / ☐ / ☐ /

GUEST FEEDING INSTRUCTIONS

Please bring your pets food pre-packaged per meal or in an air tight container only.
Feeding Instructions: (Example: Dry Dog, 1.5 Cups Dry, Twice a Day, AM & PM)
Click here to enter text.
If your pet runs out of food during their stay how would you like us to continue feeding your pet? Acana Brand available in
Chicken Greens ($1.00/Cup) ☐ Lamb & Apple ($1.50/Cup) ☐
Pacifica Fish ($1.50/Cup) ☐ Duck & Pear ($1.50/Cup) ☐
OR: Purchase your pets current food at local pet supply store at cost to owner (cost of food + $10 pickup surcharge fee) ☐

ADDITIONAL SERVICES DURING STAY Place on Page 2

Pet Taxi (Prices Vary) / ☐ / Treadmilling ($5.00/30 Minutes) / ☐ /
Full Groom (Prices Vary) / ☐ / Bath ($15.00 - $40.00) / ☐ /
Nails Clipped ($10.00) / ☐ / Nails Filed/Dremel ($13.00) / ☐ /
NO THANKS / ☐ / ☐ /

Please note we will do our best to complete requested departure services. Completion will be dependent on staff availability.

NOTE: If we are unable to reach or contact yourself or your emergency contact, and we deem it necessary your dog be attended to by a veterinarian, you accept full responsibility for any related charges and authorize the use of your credit card as provided for this purpose.
Pet Parent Signature: ______
Pet Name Printed: ______
Date: ______

ATTACH A COPY OF CURRENT VACCINATION RECORDS AND A PICTURE OF YOUR PET

Required Vaccinations: Distemper Combo & Rabies

Cancelation Policy – If 24 Hours’ notice is not given for cancellations the cost of 1 day stay will be charged to the credit card we have on file.

Page 1 of 2 Boarding Registration Form

Revised: 04/04/2017