Name
*
First Name
Last Name
Address
*
Email
*
Phone
*
(###)
###
####
Arrival Date
*
MM
DD
YYYY
Pick Up Date
*
MM
DD
YYYY
Emergency Contact
*
Emergency Contact's Phone Number
*
How did you hear about us?
From a Friend
Facebook
Flyer
Dog's Name
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Dog's Breed
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Dog's Age
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Dog's Sex
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Dog's Weight
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Has your dog been spayed or neutered? *
*
Has your dog been in any training programs? If yes, please list the training programs.
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Has your dog been microchipped?
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Who is your veterinarian?
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What is your veterinarian's phone number?
*
If my pet requires medical attention, I authorize B&G Boarding Kennels to seek medical attention at their local veterinarian. I agree to reimburse B&G Kennel for any medical bills incurred.
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How does your dog behave in the vet's office?
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Is your dog up-to-date on the following vaccinations: Parvovirus, Rabies, Bordatella, Distemper?
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Is your dog on flea/tick and heartworm prevention?
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Has your dog been tested for parasites?
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Is your dog on any medications or have any allergies? If so, please specify.
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What brand/type of food do you feed your dog?
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Does your dog obey basic commands?
*
How is your dog motivated?
*
Is your dog house-trained?
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Has your dog ever been in a dog fight?
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Does your dog ever GROWL, BARK, LUNGE OR BITE other dogs or people? If so, please specify.
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Has your dog ever shown aggression towards you?
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Does your dog let you put on/take off collars?
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Is your dog crate trained?
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Does your dog have accidents in the crate?
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Does your dog have separation anxiety?
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Is your dog aggressive when people/dogs approach their food?
*
Please check all that apply
*
Do you have anything to add about your dog?
LIABILITY WAIVER I understand that dog boarding may involve risks to me, members of my family, or my dog. I assume all risks associated with having my dog boarded and will not hold B&G Boarding Kennels or its owners/employees responsible in the event of injury to myself, family members or my dog. I agree to comply with the instructions, rules and decisions of the kennels representative as it relates to me or my dog’s ability to safely complete this boarding program. I also agree to assume all responsibility for any damage done to property, persons, or other dogs done by me or my dog’s actions. I understand that all dogs participating in the boarding program of B&G Boarding Kennels must be free of any infectious disease and must be current on all appropriate vaccinations, including bordatella, distemper, parvovirus and rabies. I understand that all dogs enrolled in the boarding program must be receiving monthly preventative treatments for the control of fleas. I confirm that the pet is currently in good health condition. I attest that my pet has a complete and updated vaccination record. I acknowledge that the pet has a collar with identification and contact information. I understand that if my dog has not been spayed, I will not hold B&G Boarding Kennels responsible for any unwanted pregnancies. I also agree that if at any point in time during the boarding program my dog comes into heat, the dog must be immediately picked up and cannot return until the dog is no longer fertile. I grant permission to B&G Boarding Kennels to use me and my pet’s photograph(s) and/or video(s) taken during boarding sessions for educational and promotional purposes in any type of media. Persons dropping off and picking up the dog must be at least 18 years old. I hereby agree and covenant for myself, my heirs, executors, administrators and anyone else who may claim on my behalf to waive, release and discharge B&G Boarding Kennels and its owners and employees from any and all claims arising out of or in connection with or in any way related this boarding program. First and Last Name
*
Attest
*
