Dog Boarding and Day Care Register

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Date and time of arrival

Date

Time

Name of dog

Microchip number

Description, breed, age and gender

Neuter status

Only sociable dogs will be permitted to board / attend daycare. By confirming your dog as sociable you are consenting to your dog being allowed to board / attend daycare with other dogs following an introductory period to ensure compatibility.

I confirm my dog as sociable.

Owner details

Name

Telephone

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Emergency Contact Name (if different)

Emergency Contact Telephone (if different)

Emergency Contact Address (if different)

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Your Vet

Name

Telephone

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Details of insurance (if any)

Medical and behavioural history and details of any treatment administered against parasites and restrictions on exercise and requirements

Details of any medical treatment your dog is receiving

Details of diet (if applicable) and related requirements including any issues relating to food and water intake

Consent to feed with other dogs

Details of your dog’s most recent worming and flea treatments with dates

Please provide proof of current vaccinations with dates (upload a scanned copy):

Click or drag a file to this area to upload.

Usual exercise pattern on a daily basis (number and duration of walks)

Preferred enrichment (eg, does your dog like kongs / tug ropes / treat puzzle toys / ball play etc)

Any other information

The above information is correct to the best of my knowledge and belief.

Name

Date

Signature

46190