Grooming Enrollment

Camp Canine Grooming enrollment

* Indicates required field

Owner's Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number (Home) *

Phone Number (Work) *

Phone Number (Cell) *

Email *

Emergency Contact (Must be someone other than you or your spouse) *

Emergency Contact Relation *

Emergency Contact Phone *

Veterinarian Clinic *

Veterinarian's Name *

Clinic Phone Number *

How did you hear about Camp Canine *

Which services are you currently interested in? Check all that apply. *

Daycare Boarding Grooming

Dog's Name *

Date of Birth *

Breed *

Is your dog: *

Male Female

Is your dog spayed or neutered? *

Yes No

Where did you acquire your dog? *

When did you acquire your dog? *

Do you have any knowledge of your dog's history? *

Is your dog crate trained? *

Yes No

Is your dog on any medications? *

Yes No

If yes, which medications? *

Does your dog have any health issues that would require restrictions on their activities? *

Does your dog have any sensitive areas on his/her body? *

Yes No

If yes, please elaborate on these sensitive areas. *

Are you aware of any skin abnormalities (lumps, warts...) on your dog? *

Yes No

Please list any skin abnormalities. *

Does your dog have any allergies? *

Yes No

Please list any allergies. *

Can your dog have treats? *

Yes No

Please list any illness or conditions that your dog has been diagnosed with in the last 5 years (Examples: hip/elbow dispasia, collapsing trachea, skin diseases...) *

Has your dog had, or been exposed, to any communicable diseases (canine cough, oral papillomas, eye infections...)? If so, specifically what and when? *

Type of flea program. *

Date of last application, *

Is there anything specific your dog is afraid of? Examples: thunder, men with hats... *

How does your dog react to baths, nail trims, tooth brushing.... *

Has your dog ever growled at or bitten a human? If yes, please elaborate on the situation. *

Veterinary Exam Form

We require all applicants to Camp Canine to have proof of vaccination on file. This allows us to better meet your dog's physical and health needs. You can download our veterinary exam form here for your veterinarian to fill out, or your veterinarian can fax us proof of vaccination.

We will need proof of vaccination prior to your grooming appointment.

Camp Canine Requirements and Policies

To ensure the health and safety of your pet and of our other guests, we require that all of our clients comply with the following rules and regulations.

Dog Grooming Requirements

All dogs must:

Be up to date on their Rabies, Distemper, and Parvo vaccines.
Have their bordetella vaccination and a negative parasite fecal screen every 6 months.
Be on flea prevention.
Be fully restrained in the parking lot, and entering and exiting the building. Dogs can be held, in a carrier, or on lead. This means to and from your vehicle.

Owners must:

Confirm that their dog has not harmed or shown aggression or threatening behavior towards any person or other dog(s).
Complete the Camp Canine enrollment packet, and provide proof of vaccination.

I/we agree to all of the above "Dog Grooming Requirements" *

Yes

Vaccination Requirements

Proof of Rabies vaccine.
Proof of DA2PP (Distemper, Hepatitis, Parvovirus, Parainfluenza) Vaccine
Proof of bordetella vaccination. Bordetella must be administered every 6 months.
Proof of negative fecal screening every 6 months..
Current on flea/tick preventatives.

I/we agree to all the above "Vaccination Requirements" *

Yes

Medical Illness Policy

If your dog becomes ill or injured, your dog will be treated as deemed best by the staff of Camp Canine, and owner agrees to assume full financial responsibility for all expenses involved. While Camp Canine will utilize all contact information given for both owner and emergency contact, should both owner and emergency contact be unreachable by phone, owner give permission to Camp Canine to allow medical charges and will accept charges up to the amount specified below for medical care while in the care of Camp Canine.

I give permission to Camp Canine to allow medical charges and will accept charges up to $__________ for medical care while in the care of Camp Canine. *

Terms and conditions

Camp Canine Doggy Daycare reserves the right to refuse services (including daycare, boarding, training and grooming) to any dog, at any time, and for any reason.

All dogs participating in daycare must have an updated Distemper/Parvo and Rabies vaccine. In addition a Bordetella vaccines and negative fecal exam will be required every 6 months. The vaccines/fecal exams must be done by a licensed veterinarian prior to their first day of daycare. All vaccination records and results of the fecal exam must be supplied to Camp Canine Doggy Daycare in a timely manner or daycare privileges may be suspended. All dogs must be on a leash when arriving and leaving the facility and must have a quick-release nylon, cloth, or leather collar on while in daycare. NO choke chains or prong collars allowed. Toys are provided so please do not bring toys from home. Any meals or medications must be supplied by you, for daycare. Please place them in a plastic bag or container with their name (first and last) on the outside and be sure to give special instructions in writing attached to the container. Food is provided for overnight stays. Only socialized dogs are allowed to participate in daycare. Any signs of aggression toward another dog or person will terminate their daycare privileges.

PAYMENT     Prepayment is required before your dog can participate in daycare. All NSF checks will be assessed a $35.00 handling fee.

VETERINARY CARE    Groups of dogs have complex interactions. There is a chance that your dog will be involved in an accident or altercation at daycare. It is almost impossible to assign blame in any altercation. In the event that your dog may need medical attention while at our facility, we will seek medical care at AllCare Pet Hospital, unless directed otherwise by you. We will attempt to reach you, if possible, otherwise we will follow your directions as written on our enrollment form if it is time-sensitive. Owner will be responsible for charges for any needed treatments, stitches, and medicines   These charges must be paid in full at the time you pick up your dog.

ADDITIONAL CHARGES        Dogs are required to be on a monthly flea control program. Camp Canine reserves the right to give any dog Frontline Top Spot Plus treatment and/or administer a flea bath and charge the client for each services deemed necessary.

LATE CHARGES       Check out time at Camp Canine Doggy Daycare is 7:00, a late charge of $1.00 per minute beyond 7:00p.m. will be charged. Late charges must be paid at the time of late pick up. If your dog has not been picked up by 7:30 p.m., he/she will be bedded down for the night on site, if kennels are available, or at All Care Pet Hospital. Full overnight and late fee charges will be assessed and must be paid before your dog is released to you.

I/we agree to all the above "Terms and Conditions" *

Yes

Release of Liability

Please read carefully before signing.
I agree to pay promptly, in full, at time of pick up of said pet any and all charges incurred by Camp Canine Doggy Daycare for care of our dog. I also give permission for any veterinary care deemed necessary for the pet's health and well-being and will be solely responsible for payment of any charges incurred for such care and treatment. My signature on this form is proof of acceptance to all of the terms and conditions and release of liability clause. Signatures are required before any services will be rendered by Camp Canine. This agreement has no time limit and is valid and enforceable for any and all future stays for my pet(s) at Camp Canine Doggy Daycare

I certify that I have read, and fully understand, all the terms and conditions. I agree to release Camp Canine Doggy Daycare, its owners and employees from all liability should any illness or injuries, mild or severe, be inflicted upon or sustained by my pet while in the care of Camp Canine.

I/we agree to the above "Release of Liability" *

Yes