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Registration Form - Camp Un-Leashed
All information is required
*
Indicates required field
Owner Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Email
*
Home Phone
*
Cell Phone
*
Vet Name
*
Vet Phone
*
Emergency Contact
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Dogs Name
*
First
Last
Breed
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Spayed/Neutered
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Spayed
Neutered
Sex
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Male
Female
Dog's birthday
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Weight
*
Licensed
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Yes
No
Tattoo/Microchip Details
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Flea/Tick Program
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Yes
No
Food Type/Brand
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Feeding/Medication Instructions
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Pet Habits/Allergies/Additional Information
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Does your dog go to the Dog Park?
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Yes
No
If yes, how does he/she do? Please explain
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Does your dog go to Doggy Daycare?
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Yes
No
Has your dog ever been in a dog fight?
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Yes
No
If yes, what were the circumstances?
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Does your dogs behavior depend on the size, breed or gender of other dogs?
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Yes
No
If yes, please explain
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Are there any problematic behaviors we might need to keep an eye on?
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Is your dog food or toy possessive?
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Yes
No
Has your dog been left overnight before?
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Yes
No
Were there any behavioral problems either while you were away or upon your return?
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Yes
No
If yes, please explain
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Has your dog ever run away for any reason (chasing cat, dog, looking for you, etc?)
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Yes
No
If yes, please explain
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Please describe your dog’s general temperament
*
Customer Standard Agreement
1. Our Town Kennels agrees to exercise due diligence in the care of my dog. In addition, Our Town Kennels agrees to keep its premises sanitary and properly enclosed. My dog will be cared for by Our Town Kennels staff only, without liability on Our Town Kennels part for loss or damage from disease, theft, fire, death, escape, injury or harm to persons, other dogs or property by my dog, or from other unavoidable causes, due diligence and care having been exercised by Our Town Kennels.
2. Should my dog become ill or seem to be in need of medical consideration, Our Town Kennels reserves the right to administer aid and/or to use any available veterinarian. I shall pay any expenses so incurred in addition to fees incurred for boarding services provided by Our Town Kennels.
3. My dog is in good general health, and valid proof that he/she is current on Rabies, DHLPP, Bordatella and Parvovirus vaccinations will be provided before she/he can stay at Our Town Kennels. Dogs arriving with fleas and/or ticks will be bathed at the owner's expense.
4. I agree that my dog may be videotaped, photographed, and/or recorded. Our Town Kennels shall be the exclusive owner of the results and all such tapings, photography, and recordings will be used only by Our Town Kennels in its own promotion, advertising, sale or publicizing.
5. Should my dog exhibit inappropriate aggressive behavior toward other dogs or people, for the safety of all concerned he or she will be placed in a secure dog run or temporarily relocated to a conventional boarding facility.
6. Our Town Kennels reserves the right to refuse any dog.
I UNDERSTAND AND AGREE TO THE CONDITIONS STATED ABOVE CUSTOMER AGREEMENT
*
Agree - please check box
Veterinarian Clearance
*
I agree to bring documentation from my vet verifying vaccination history at which time our contract of services will be signed
Submit
We try our best to accommodate everyone, if you have any questions please contact Sue at
603-924-7116
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