Name *

First Name

Last Name

Spouse

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone - Cell *

(###)

###

####

Phone - Home

(###)

###

####

Phone - Work

(###)

###

####

Name *

First Name

Last Name

Phone *

(###)

###

####

Name

First Name

Last Name

Phone

(###)

###

####

Check-in Date *

MM

DD

YYYY

Time

Hour

Minute

Second

AM PM

Check-out Date *

MM

DD

YYYY

Time

Hour

Minute

Second

AM PM

Name *

First Name

Last Name

Sex *

Male

Female

Spayed/Neutered *

Yes

No

Has your dog ever boarded at a kennel before? *

Yes

No

2nd Pet Name

First Name

Last Name

Sex

Male

Female

Spayed/Neutered

Yes

No

Has your dog ever boarded at a kennel before?

Yes

No

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Flea and tick prevention: *

Yes

No

Heartworm prevention: *

Yes

No

Does your pet have any of the following conditions?

Hip dysphasia

Allergies

Arthritis

Epilepsy/Seizures

Sensitive areas on body

Skin conditions, mange or “hot spots”

Has your pet ever suffered from any serious illness?

Yes

No

Has your pet ever been in a serious accident of any kind?

Yes

No

Does your pet have separation anxiety?

Yes

No

Does your pet have any other medical conditions, injuries or history of which Pampered Paws Spa should be aware of?

Yes

No

Do you have any other pets in your household?

Yes

No

Is your pet protective of you or other pets in your household?

Yes

No

Is your pet aggressive with other animals or humans?

Yes

No

Has your pet ever bitten other animals or humans?

Yes

No

Do you consider your pet social with other animals?

Yes

No

Is your pet possessive with toys or food with other animals or humans?

Yes

No

Is your pet trained in any way?

Yes

No

Does your pet jump fences?

Yes

No

Does your pet dig holes?

Yes

No

Is your pet house broken?

Yes

No

Is your pet afraid of any of the following?

Loud noises

Thunder

People

Other

Are there any special places your pet likes to be petted?

Yes

No

Is your pet crate trained?

Yes

No

Please indicate brand (what), when and portions of food should be given to your pet. *

Per pet

Dry

Canned

Morning

Afternoon

Evening

Are there any special feeding instructions? *

Yes

No

Does your pet require any medications? *

Yes

No

Are there any other special care instructions? *

Yes

No

Date *

MM

DD

YYYY

Date *

MM

DD

YYYY

APPLICATION FOR GROUP PLAY-TIME WAIVER

Agreement to Hold Harmless, Waiver and Assumption of Risk I want my dog(s) to receive exercise/ playtime with other dogs at Pampered Paws Spa. My dog is well socialized with other dogs. My dog will not attack or bite another dog. I understand that this is not without risk to my dog, because some dogs may bite or injure each other while playing. I understand that it might take a while for dogs to become accustomed to group play. Initially their feet may get sore until they become accustomed to playing on a hard, porous and uneven surface. Generally this soreness does not present a problem and goes away after the dog has spent a few days playing at the kennel. I understand that my dog’s feet might get tender if s/he runs or plays hard in the gravel play area. I hereby waive and release Pampered Paws Spa and its employees, from any and all liability of any nature, for any injury or damage which my dog may suffer, including specifically, but not without limitation to, any injury or damage resulting from the action of any dog and I expressly assume the risk of such damage or injury. In consideration of and as inducement to the acceptance of my application for my dog’s participation in group exercise/ play with other dogs at Pampered Paws Spa, I hereby agree to indemnify and hold harmless Pampered Paws Spa and its employees from any and all claims.

Dog 1

Dog 2

Date *

MM

DD

YYYY