Application

Be Cuz We Care Doggy Day Care

Daycare Registration Form

General Information

Pet Information:

Name: Breed: Sex:

Age: Weight: Birthdate:

Have you had your dog since puppyhood? Yes No If yes, how long?

Where was your dog purchased? Breeder SPCA Other

How many days/weeks are you considering doggy daycare? Preferred days?

How did you hear about Be Cuz We Care doggy daycare?

Health:

Is your dog neutered/spayed?

Is your dog current on ALL vaccinations? Yes No

What method of flea control is used?

Any injuries old/new:

Allergies?

May your dog have treats during the day?

Behaviour:

Does your dog act afraid of any specific items or noises? If so, please explain:

Are there any kinds of dogs your dog automatically fears or dislikes?

Does your dog have any problems in the following areas: If so, please explain:

Whining, barking, jumping, house training, digging, other?

Does your dog exhibit any aggressive tendencies? (e.g. food/toy) Please explain.

Has your dog had any formal obedience traning? Yes No

What commands does your dog understand?

Please tell us anything else about your dog that you feel might be helpful:

Be Cuz We Care Doggy Day Care

Owner Information:

Name:

Address:

Home Phone: Work Phone:

Cell Phone:

Email:
Is it alright to send pictures/updates to this email? Yes No

Emergency contact - other than yourself:

Name:

Home Phone: Work Phone:

List any person authorized to pick up your dog if you cannot:

Veterinarian:

Name:

Address:

Phone:

Be Cuz We Care Doggy Day Care

Terms and Conditions Agreement

I hereby certify that my dog(s) is/are in good health and have not been ill with any communicable condition in the past 30 days.

_____ 1. I understand that I am responsible for any harm or damage caused by my dog while my dog is in the care of Be Cuz We Care. I shall indemnify and hold harmless Be Cuz We Care for any claims made against Be Cuz We Care or their staff. I understand and agree in admitting my dog(s) to Be Cuz We Care, the facility has relied on my representation that my dog(s) is/are in good health, is/are not agressive and has/have never harmed or show aggressive or threatening behaviour toward any person or other dog.

_____ 2. I understand and agree Be Cuz We Care will not be liable for problems, damage or injury cased by my dog provided reasonable care and precautions are followed by daycare staff. I release Be Cuz We Care from any liability arising from my dog's attendance and participation at the daycare. I understand this is a place where dogs co-mingle in groups. I understand my dog may be placed in a crate for "time-outs" not to exceed twenty minutes or if injured. I understand when dogs play in groups, nicks and scratches may occur. Be Cuz We Care staff may not notify me immediately if it is not a serious injury and, will notify me when I pick up my dog. If the injury is serious, I will be notified immediately.

_____ 3. I understand and agree any problem or injury that develops with my dog will be treated as deemed best by Be Cuz We Care, at their sole discretion. I assume full financial responsibility for any and all expenses involved.

_____4. I recognize that there are inherent risks of illness or injury when dealing with animals. Such risks include, but are not limited to, problems resulting from rough play and canine cough (doggie colds).

_____ 5. I, as the owner, agree to be solely responsible for any and all acts or behaviour of my pet while in the care of Be Cuz We Care. If my pet should become ill or seem to be in need of immediate medical consideration, Be Cuz We Care reserves the right to administer aid and/or to use any available veterinarian. I, the owner shall pay any expenses so incurred.

_____ 6. I allow my dog to be photographed, videotaped and/or used in any media or advertising without prior approval by me. All such photographs, etc. are the property of Be Cuz We Care. (e.g. photos for website, video for public viewing, photos for public viewing) Yes No

DAYS AND HOURS:

Monday through Friday: 6am to 7pm CLOSED: Saturday and Sunday

Preference will be given to those with reservations. Same day cancellations may becharged full fees.

Be Cuz We Care Doggy Daycare reserves the right to refuse a visit for any reason.

I certify that I have read and understand the above agreement. I accept all the terms, conditions and statements of this agreement.

Owner's name: Dated:

Owner's Signature: _________________________________________

Please, enter your information now and print this