Daycare Application

Owner Information
1. First & Last Name:
2. E-mail address:
3. Home Phone:
4. Cell Phone:
5. Mailing Address:
Street Address City State / Province / Region ZIP / Postal Code

General Information
1. How did you hear about Doggy Daycare?
2. Dog's Name
3. Dog's birth date:
Date Format: MM slash DD slash YYYY
4. Dog's breed and sex:
5. How long have you owned your dog?
6. Where did you get your dog?
7. If adopted, do you have any knowledge of your dog's past history?
8. How many people are there in your household?
Male (adult)
Female (adult)
Male/ages (children)
Female/ages (children)
9. Does your dog like children?
- Yes
- No
10. How does your dog behave around children?
11. Are there other animals in your household?
- Yes
- No
12. If yes, list other animals by species, breed, whole/altered, ages and sex:
13. How does your dog get along with other resident animals?

Health/Grooming
1. Does your dog have a problem with fleas?
- Yes
- No
2. Does your dog have hip dysplasia?
- Yes
- No
If yes, what restrictions need to be placed on your dog's activities or movements?
3. Does your dog have allergies?
4. Does your dog like to be brushed?
- Yes
- No
If not, what have you tried to make brushing more enjoyable?
5. How often do you brush or comb your dog's coat?
6. What kind of brush and/or comb do you use on your dog?
7. How does your dog react to having his/her nails clipped?
8. Does your dog have any sensitive areas on his/her body?
9. Where are your dog's favorite petting spots?

Behavior
1. Do any visitors bring their dog(s) to your house?
- Yes
- No
If yes, how do they get along?
2. How does your dog react to a stranger coming into your home or yard?
3. Does your dog ever bark or growl at anyone passing outside your home or yard?
- Yes
- No
4. Are there any kinds of people your dog automatically fears or dislikes?
5. Are there any kinds of dogs your dog automatically fears or dislikes?
6. How does your dog react to puppies?
7. Does your dog know any tricks?
8. What does your dog do when you're not at home?
9. How does your dog act when you get home at the end of the day?
10. What does your dog do to show he/she is happy?
11. How does your dog react to another dog approaching it in a park, at the beach or on a walk?
a. On lead
b. Off lead
12. How many times a week is your dog walked outside?
13. How long are your walks?
14. Has your dog ever jumped up on someone?
- Yes
- No
What were the circumstances?
15. Growled at someone?
- Yes
- No
What were the circumstances?
16. Bitten someone?
- Yes
- No
What were the circumstances?
17. Has your dog ever climbed a fence?
- Yes
- No
18. Does your dog have any problems in any of the following areas (check all that apply):
- Mouthiness
- Housetraining
- Barking
- Digging
- Ignoring commands
Other comments or information about your dog that you feel might be helpful:
19. Is your dog frightened by any noises?
- Yes
- No
If yes, what noises?
20. Is your dog frightened of or nervous around anything else?
21. Has your dog ever shared his/her food or toys with other animals?
- Yes
- No
22. Does your dog play with any toys?
- Yes
- No
If yes, what kind of toys does your dog like and what games does he/she play with their toys?
23. Does your dog play with other dogs?
- Yes
- No
24. What kind of dogs does your dog like to play with?
25. Does your dog prefer to play with male or female dogs?
- Male
- Female
- Both
26. What kind of games does your dog play with other dogs?
27. What kind of games does your dog play with people?
28. Has your dog ever been on any agility equipment?
- Yes
- No
29. Do you know of any reason that your dog might not like, or be unable to use, the agility equipment we have here?
30. Has your dog ever had any formal obedience training?
- Yes
- No
If yes, when and where?
31. Do you walk your dog on your left side or your right side?
- Left
- Right
32. What kind of a collar do you use to walk your dog?
33. Is it effective in keeping them under control?
- Yes
- No
34. Does your dog know any commands?
35. Does your dog know a bathroom command?
36. Does your dog know any play command?
37. Does your dog have a quiet command?
CARE FOR YOUR PET
1. Fuzzie Buddies shall exercise reasonable care for your pet for the duration of the pet’s stay. However, if your pet becomes ill or if the state of the pets health otherwise requires professional attention, Fuzzie Buddies, in its sole discretion, may engage the services of a veterinarian, administer medicine or give other requisite attention to the pet and the expenses thereof shall be paid by the owner.
OWNER ASSURANCES
1. Owner specifically represents to Fuzzie Buddies that their pet(s) has not been exposed to rabies, distemper or been ill within a thirty-day period prior to boarding. Owner also agrees to be solely responsible for all acts of behavior of their pet while in the care of Fuzzie Buddies.
2. It is expressly agreed by Owner and Fuzzie Buddies that Fuzzie Buddies liability shall in no event exceed the lesser of the current value of the pet of the same species or the sum of $100.00 per pet boarded.
3. I agree to allow Fuzzie Buddies to use my pet’s name, images or likeness taken while at Fuzzie Buddies, for use at any time, in any media, marketing, advertising, illustrations, trade or promotional material.
4. By signing this contract, the owner certifies the accuracy of all information given to Fuzzie Buddies and that they are the sole owner of the pet free and clear of all liens and encumbrances.
PAYMENT OF CHARGES INCURRED
1. Owner agrees to pay the rate for boarding in effect on the date of pet check-in and to pay all costs and charges for special services requested and all veterinary costs during the time the pet is in the care of Fuzzie Buddies.
2. All charges incurred by the Owner shall be payable upon pick-up of their pet. Owner also agrees that their pet shall not leave Fuzzie Buddies until all charges are paid.
3. Fuzzie Buddies shall have, and is hereby granted a lien on the pet for any and all unpaid charges resulting from the pets stay at Fuzzie Buddies. If not paid, Fuzzie Buddies may exercise its lien rights upon ten days written notice given to Owner by certified mail to address shown on this contract. Fuzzie Buddies may use the pet as compensation for any and all unpaid charges.
CONTRACT TERMS AND CONDITIONS
1. This contract contains the entire agreement between the parties. All terms and conditions of the Contract shall be binding on their heirs, administrators, personal representatives and assigns of the Owner and Fuzzie Buddies.
2. Any controversy or claim arising out of, or relating to this contract, or the breach thereof, or as the result of any claim or controversy involving the alleged negligence by any party to this contract or the breach thereof, or as the result of any claim or controversy involving the alleged negligence by any party to this contract, shall be settled in accordance with the rules of the American Arbitration Association and judgment upon the award rendered by an arbitrator may be entered in any Court having jurisdiction thereof. The arbitrator shall, as part of his award, determine an award to the prevailing party of the cost of such arbitration and reasonable attorneys fees of the prevailing party.
3. This agreement includes release of liability and wavier of legal rights and deprives the owner of the right to sue Fuzzie Buddies, LLC.
Electronic Signature of Owner*
By typing my name here:*
I signify that the above information is true and that I agree to abide by the terms of this agreement. Date (MM/DD/YR):*
Name
This field is for validation purposes and should be left unchanged.

Step 1 of 4

Owner Information

General Information

Health/Grooming

Behavior

CARE FOR YOUR PET

OWNER ASSURANCES

PAYMENT OF CHARGES INCURRED

CONTRACT TERMS AND CONDITIONS

Electronic Signature of Owner*

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