Daycare Application 2018

 Woofers 4C newtagline_2015_350

Dog Daycare & Boarding Application For:                                                   

Pet Owner Info                                                                             

Guardian/Human’s Name: __________________________________________________

Mailing Address: _________________________________________________________

Home Phone #: (____)_________    Work #:(____)___________     Cell #: (___)__________

Emergency Contact: (Not YOURSELF & NOT TRAVELING WITH YOU)_____________________

Home/Cell Phone # of emergency contact: _________________________________________

Persons authorized to Drop-off/Pick-up my dog(s): ___________________________________

How do you plan to use Woofers’ Doggie Daycare? (Check all that apply)

___ Play once a week      ___2-3 times per week    ___Boarding           ___Temporarily

Health Record

Dog’s Name: ___________________       Age: _______        Sex: ______     Breed________________________

Spayed/Neutered: _____________         Veterinary Clinic & Doctor’s Name: _________________

Do you plan to Spay/Neuter your dog at 6 months of age? If not, when? ______________________

 

Does your dog have any restrictions on activity? ______________________________________

Is your dog on any medications, any health concerns?___________________________________

Does your dog receive heartworm, flea and tick preventatives? ____________________________

Canine Info

We need to know your dog(s) as well as you do! Please answer the following questions so that we have a better understanding on the behavior of your dog.

Has your dog ever been to dog daycare before? If so, where?_____________________________

How is your dog’s temperament around other dogs? __________________________________

How is your dog’s temperament around strangers? ___________________________________

Does your dog have any fears or obsessions? _______________________________________

Has your dog ever bitten anyone? ______________________________________________

Does your dog jump on people? _______________________________________________

Does your dog dig?________________________________________________________

Does your dog jump fences? If so, how high? (4 foot, 6 foot?) ____________________________

Is your dog crate, food, or toy aggressive? _________________________________________

Is your dog house or crate trained?______________________________________________

Please check any boxes that apply to your dog

__Mellow/Calm        __Shy/Submissive                 __Playful                             __High Energy

__Dominant/Alpha  __Well-Behaved                    __People Aggressive          __Dog Aggressive

__Toy Possessive       __Vocal                                   __Escape Artist                  __Rough player

__Excessive Barker   __Digger                                 __Growls at Strangers      __Eats Rocks

__Feces Eater             __Separation Anxiety           __Destroys Furniture       __Runs Away

__Fear of Noises        __Jumps Fences                    __Destroys Toys                __Chewer

Is there anything else that we need to know about your dog?___________________________

References

Please provide references for your dog.  This person should be familiar with your dogs behavior around stranger(s) and other animals.  Please include any current Woofers’ clients who have referred you to us!

Name:_____________    Phone number:_______________Relationship:_________________

Name:_____________    Phone number:_______________Relationship:_________________

Name:_____________    Phone number:_______________Relationship:_________________

Boarding & Daycare Agreement

1) Owner certifies the accuracy of all information conveyed about the owner’s pet(s) to Woofers .

2) Owner authorizes the Facility to obtain medical and vaccination records for the pet(s) listed above from the veterinarian listed above. Owner further authorizes said veterinarian to provide these records to the Facility.

3) Owner agrees not to bring pet(s) to Facility if pet(s) exhibit any signs of illness that may be harmful to the other pets in attendance, such as: vomiting, diarrhea, coughing, extreme lethargy, etc. without first obtaining approval from the Facility.

4) Facility shall exercise reasonable care for owner’s pet(s) while it/they is/are in the Facility’s custody. The owner recognizes the potential risks (such as illness and/or injury) involved with pet daycare, boarding and grooming. The Facility does not allow any aggressive pets for boarding, daycare or grooming.

5) Facility may change the level or type of daycare/boarding or possibly remove the pet(s) from group play, if Facility believes it necessary to ensure the safety of the owner’s pet(s), other pets or its employees.  Dogs must be in attendance within any 30 day period in order to ensure the ability to attend daycare.

6) Owner represents to the Facility that owner is over 18 years of age; that all information provided about the owner is accurate; and that all credit card information provided is accurate.

7) Owner agrees to the Policies and Procedures posted in the Facility’s lobby and on its website on check-in date. The Facility reserves the right to adjust said Policies and Procedures without prior notice.

8) Owner gives the Facility consent to act in the owner’s behalf to obtain veterinarian services if owner’s pet(s) become(s) ill or require(s) the attention of a veterinarian. The owner agrees that the Facility, in its sole discretion, may engage veterinarian services, administer medicine, or give other requisite attention to the pet(s); that all expenses incurred shall be paid by the owner; and agrees to indemnify and hold the Facility and its employees harmless from said expenses.

9) Owner agrees to pay all charges incurred for: special services requested veterinary costs as stated above, and failure to comply with the Facility’s Cancellation Policy.

10) Facility shall have the right to refuse to release owner’s pet(s) until owner has paid all charges due to the Facility. The Facility is hereby granted a lien on the owner’s pet(s) for any and all unpaid charges resulting from boarding, day care or any other service provided by the Facility.

11) Owner assumes any and all liability and expenses for injuries inflict upon any human or other pet(s) by owners pet(s) while in the Facility. Owner agrees to indemnify and hold the Facility and its employees harmless from any and all liability and expenses incurred as a result of said injuries.

12) Facility has the right to take photographs and/or videos of owner’s pet(s) while in the Facility’s care. The Facility may post or reproduce any and all photographs/videos taken (as well as pet(s) name) on or in, without limitation, the Facility’s website, social media sites or promotional materials without becoming liable to the owner (or the owner’s pet(s)) for any royalty payment. Owner hereby releases, covenants not to sue, and forever discharges the facility of and from any and all claims, demands, rights, and causes of action of whatever kind or nature. Further, owner agrees that no photography or video may be taken by the owner while in the Facility without approval from Facility’s Corporate Offices.

13) Owner agrees that the Facility’s liability shall not exceed the current chattel value of a pet of the same species delivered to the Facility.

14) This Agreement contains the entire agreement between the parties and shall be binding on the heirs, administrators, personal representatives and assigns of the owner and the Facility.

15) Owner releases, indemnifies and holds the Facility harmless from any and all manner of damages, claims, losses, liabilities, costs or expenses, causes of action or suits, whatsoever in law or equity (including, without limitation, attorney’s fees and related costs) arising out of or related to the services provided by the Facility, except which may arise from the sole gross negligence or intentional and willful misconduct of the Facility, including, without limitation:

  • Any inaccuracy in any statement made by owner or information provided by owner to the Facility;
  • Your pet(s), including but not limited to destruction of property, pet bites and transmission of disease;
  • Any action by owner which is in breach of the terms and conditions of this Agreement.

16) Any controversy or claim relating to this Agreement shall be settled by arbitration in accordance with the rules of the American Arbitration Association. Judgment upon the award rendered by an arbitrator may be entered in any court having jurisdiction thereof. The arbitrator shall, as part of his/her award, determine an award to the prevailing party of the costs of such arbitration and reasonable attorney’s fees of the prevailing party.

17) This is an Agreement between Woofers and/or Moxie Dog, L.L.C. (referred to as “Facility”) and the pet(s) owner whose signature appears below (referred to as “owner”).

 

Print Name:_______________________________

Signature:________________________________

Date:____________________________________