Please complete the application form below if you wish to enrol your dog for Doggy Daycare. Once you have completed the form, we will be in touch to arrange a consultation prior to admittance to daycare. At the end of the form, you will be sent a copy of your responses for future reference. To help ensure the health and safety of your dog and those already in our care, please provide as much detailed information as possible throughout the application form. Owner detailsDog detailsPlease enter the following information about your dog. MedicalVet detailsDeclarationPlease agree to the declaration below and complete your details. A physical signature will be requested at your consultation appointment. Owner detailsOwner nameTelephone/mobile numberAddressPartner/spousePartner/spouse namePartner/spouse telephone/mobile numberPartner/spouse emailPartner/spouse addressDog detailsNameDate of birthBreedColourSexWeightMicrochip numberWhat days and times do you require your dog to attend daycare?Neutered/spayedHas your dog been neutered/spayed?If so, what age were they neutered/spayed?WhereFrom where did you get your dog?Did you adopt your dog?If so, please give a brief description of your dog's historyHouseholdHow many dogs are there in the household?Has your dog ever bitten anyone?Is your dog protective/territorial?Has your dog ever shown any signs of aggression?Has your dog ever been involved in any kind of incident?If you answered yes to any of the above, please provide more informationSocialisationIs your dog child friendly?Does your dog socialise well with others?Please give details of any training givenIs your dog friendly towards other animals (i.e. cats, other domestic animals, farm animals, wildlife)?ConditionsDoes your dog have any pre-existing or current health conditions?If yes, please provide detailsHas your dog been ill in the last 30 days?Has your dog ever had a seizure?Does your dog have any allergies?Does your dog have hip dysplasia?Does your dog have any sensitive areas on their body?Does your dog have any physical limitations that need special attention or that may prevent certain types of play?If you answered yes to any of the above, please provide more informationMedicationIs your dog on any medication?If yes, please provide more detailsAttentionDoes your dog enjoy being brushed?Is your dog happy to have their nails clipped?Is your dog allowed treats whilst at daycare?Vet detailsVet practice nameVet telephoneVet addressVaccinationsPlease provide the date your dog last received vaccinations below. Vaccination standard (DHPP)Bordatella (Kennel Cough)Last flea treatmentFlea and tick prevention method usedPlease note: We will expect to see your dog's vaccination records at the consultation. DeclarationI (the owner) confirm to Cheshire School of Dogs that I am legal owner of my dog. I agree to the above terms and conditions.The information I have given in this form is true, correct and complete to the best of my knowledge. I hereby release Cheshire School of Dogs LTD, their staff, and volunteers of any liability of any kind whatsoever arising from my dogs’ attendance and participation at Daycare. |