LUCKY DAWG DAYCARE APPLICATION

By completing the form below, I hereby certify that
My dog(s) is (are) in good health and have not been ill with any communicable conditions in the last 30 days.
My dog(s) have not harmed or shown aggressive or threatening behavior toward any person or any other dog.
I have read and understand the following:

1. I understand that I am solely responsible for any harm caused by my dog(s) while my dog(s) is/are attending
Lucky Dawg (“Center”). I agree to hold harmless & indemnify Kathy Jackson of Lucky Dawg Daycare, any and all
persons who might assist in the care of my pet, or from any claim for damages and/or injuries to my pet and property.

2. I further understand and agree that in admitting my dog(s) to be the Center, Lucky Dawg staff have relied on my representation that my dog(s) is/are in good health and have not harmed or shown aggressive or threatening
behavior toward any person or any other dog.

3. I further understand and agree that Lucky Dawg Daycare Center and their staff and volunteers, will not be liable
for any problems which develop, provided reasonable care and precautions are followed, and I hereby release them
of any liability of any kind whatsoever arising from my dog(s) attendance and participation at the Center.

4. I further understand and agree that any problems which develop with my dog(s) will be treated as deemed best
by staff and volunteers of Lucky Dawg Daycare, at their sole discretion, and that I assume full financial responsibility
for any and all expenses involved.

I certify that I have read and understand the policies of the Center as set forth on the preceding pages and that
I have read and understand the conditions, statements of this agreement, including the following:

FEES: Fees are based on a pass plan. A pass is valid for 6 months from date of purchase.

DAYS & HOURS: Monday through Friday from 7:30am to 6:00pm. The Center is not anovernight facility.
There will be a $1.00 per minutes charge for any pet left after 6:00pm.

RESERVATIONS: Required. Cancellations with less than 24 hours notice will be charged full fees.

OWNER AGREEMENT, PET PERSONAILTY & EMERGENCY CONTACT INFORMATION
Please complete this form for each pet who wishes to attend Lucky Dawg.

Owner Name
Dog Name
Today's Date
Owner Signature (Typed)
How did you hear about Lucky Dawg Daycare?
Date Dog Was Acquired
Breed, Sex, Birthdate & Weight
Age When Spayed or Neutered
Where Owner Acquired Dog
If Adopted, Knowledge of Dog's History
Does Dog Like Children?	Yes No
Type, Sex & Age of Other Animals in Household
Does Dog Get Along with Other Resident Animals?	Yes No
Specific Items or Noises Dog Dislikes or Fears
Types of People Dog Dislikes or Fears
Types of Dogs Dog Dislikes or Fears
Describe Any Growling or Biting
Check if Dog Has Problems With	Mouthiness Barking Jumping Housetraining Digging Other
Toys or Games Dog Enjoys
Does Dog Play With Other Dogs?	Yes No
Formal Obedience Training	Yes No
Commands Dog Knows
Dog's Allergies
Hip Dysplasia Restrictions
Does Dog Like to be Brushed?	Yes No
Does Dog React to Nail Clipping?	Yes No
Does Dog Have Any Sensitive Areas?
Favorite Petting Spots
Other Comments About Your Dog
Owner Home Address
Owner Home Phone
Owner Work Phone
Owner E-mail
Emergency Contact
Emergency Contact Home Phone
Emergency Contact Work Phone
Veterinarian
Veterinarian Address
Veterinarian Phone	email forms
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