Dog Day Care Registration Form

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Owner Information
Name(s)
Mailing Address
City
Zip
Primary Phone
Secondary Phone
Alternate Contact
Alternate Contact Phone
Camper(s) Information
Dog 1:
Name
Breed
Color
Sex
Spayed/Neutered
Birthday/Age
Weight
Notes
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Dog 2:
Name
Breed
Color
Sex
Spayed/Neutered
Birthday/Age
Weight
Notes
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Dog 3:
Name
Breed
Color
Sex
Spayed/Neutered
Birthday/Age
Weight
Notes
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Veterinarian
Clinic and/or Veterinarian Name
Clinic Phone
Fax
Required Vaccinations
How were you referred to us
Check all that apply
General Information
How long have you had your dog?
What is your dog's overall level of exercise?Check the one box that best applies
What games does your dog play with other dogs?Check all that apply
What games does your dog play with people?Check all that apply
Behavior
1. Has your dog ever climbed over a fence? How tall was the fence?
2. How does your dog react to loud noises and/or thunderstorms?
3. How does your dog get along with other animals in your household?
4. Does your dog play with other dogs?
5. Do you take your dog to different places and meet new people, on walks, errands and trips?
6. How does your dog react to people you meet outdoors or out on walks?
7. How does your dog react when she meets a dog while ON leash?
8. How does your dog react when she meets a dog while OFF leash?
9. How does your dog behave at fences, windows or other barriers toward dogs or people?
10. How does your dog react if you take away her/his food or toys?
11. What's the worst bite your dog has inflicted on a person
12. What's the worst bite your dog has inflicted on a dog?
Anything else we should know about your dog?
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Waiver and Signature
Group Play PermissionMy dog(s) may participate in supervised play group with other dogs if s/he meets all the qualifications that are appropriate for participation as determined by Cascade pet Camp staff. If I permit my dog(s) to participate in group play, I certify that s/he is non-aggressive and has not caused harm to humans or other dogs. I understand that I am fully responsible for my dog(s) actions during group play.
Please read and sign your name in the box below and check the box.1. I certify that I am the legal owner of the pet(s) described above, and I am leaving the above named pet(s) in the care of Cascade Pet Camp LLC. 2. I agree to pay Cascade Pet Camp LLC the rate that is in effect upon the check-in date for care of my pet(s) and for all special service(s) requested. All returned checks and a $25 returned check fee will be electronically presented for payment. 3. Should my pet become ill or injured, Cascade Pet Camp LLC will make every attempt to contact me immediately. However, Cascade Pet Camp LLC shall have the right to call a veterinarian and make medical decisions if I cannot be reached and/or my pet’s(s’) condition requires immediate action. I accept responsibility for all costs and veterinary care. Furthermore, should my pet pass away during my absence I direct that a veterinarian be called to safe keep my pet until I return. 4. I certify that by signing this contract I have given complete and accurate information for myself and my pet(s). I understand and agree that Cascade Pet Camp LLC and its staff will not be liable for any problems that develop with my pet(s) provided reasonable care and precautions are followed. I hereby release them from any liability, including, but not limited to, loss or damage due to disease, death, running away, theft, fire, injury, to persons, other pets, or property, or other unavoidable causes, arising from my pet’s(s’) stay at Cascade Pet Camp. I understand that I am solely responsible for any harm to persons or animals caused by my pet(s) or any property damage caused by my pet(s) while my pet(s) are in the care of Cascade Pet Camp LLC 5. Cascade Pet Camp LLC may photograph my pet(s) and use such pictures for publicity or promotional purposes without any liability or obligation to me.
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