Daycare Application Form

• Date of First Visit (Bookings are required)

Guardian Information

• Guardian Name
• Address
• City
• State/Province/Region
• Postal Code
• Country
• Home Phone
• Work
• Cell
• Email

Emergency Contact

• Name
• Home Phone
• Work
• Cell

Pet Information

• Dogs Name
• Breed
• DOB/Age
• Sex
  MaleFemale
• Spayed/Neutered
  YesNo

Dog 2

• Dogs Name
• Breed
• DOB/Age
• Sex
  MaleFemale
• Spayed/Neutered
  YesNo

Others authorized to pick up your dog

• (Please note: You dog will not be released to any person not listed below).
• Full Name
• Full Name

Veterinarian Information

• Veterinarian's Name
• Address
• City
• State/Province/Region
• Postal Code
• Country
• Phone

Medications

• Is your dog up to date on vaccinations? YesNo
• Is there any Medical Condition currently being treated?
• Name of Medication
• Dosage
• # times per day
• Administered With or Without Food?

General Information

• Where did you get your dog?
• How old was your dog when you got him/her?
• Has your dog ever attended daycare before? YesNo
• Has your dog attended training classes? YesNo
• If so which courses.
• What commands does your dog understand?
• Is your dog house trained? YesNo
• Is your dog crate trained? YesNo
• Does your dog growl, bark, snarl, snap, or lunge at other dogs? YesNo
• If Yes Explain
• Does your dog dig? YesNo
• Does your dog eat rocks? YesNo
• Does your dog exhibit coprophagia (eating feces)? YesNo
• Does your dog jump on people? YesNo
• Does your dog bark often? YesNo
• Has your dog shown any destructive behaviour when you are not home? YesNo
• Has your dog ever jumped or climbed a fence? YesNo
• If so how high was the fence
• Has your dog been in a fight with another dog? YesNo
• Does your dog exhibit prey drive? YesNo
• What is your dog’s energy level (1 being low – 10 being high) 12345678910
• Overall, does your dog get along with other dogs? YesNo
• If no explain
• Is there certain types of dogs your dog dislikes? YesNo
• If so please explain
• Has your dog ever displayed aggression towards a person? YesNo
• If yes please explain
• Does your dog have any sensitive areas on his/her body that he/she does not like touched? YesNo
• If yes please explain
• Are you able to remove objects from your dog’s mouth? YesNo
• Are there any type of dogs/people your dog fears or dislikes? YesNo
• If yes please explain

Do you consent to your dog participating in Centre Activities?

• (Included in your Dog’s Daycare Day at no additional cost)
• Water play YesNo
• (I understand my dog may come home a little damp, although we will endeavour to dry off your pooch before home time)
• Agility activities YesNo
• How did you hear about us?
• Other comments or information about your dog that you feel might be helpful

 

Verification

• Please enter any two digits with no spaces (Example: 12) *
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