Cloud Nine Canines Boarding and Day Care Agreement Contact Information Your Name: Address: City:  State:  Zip: Email: Home Phone: Work Phone: Cell Phone: Emergency Phone: Pet Information Pet’s Name: Breed: Age:  Birthday: Sex: Please check all of the following boxes that apply to your pet:     Spayed or neutered     Boarded or attended day care before     Housetrained     Can jump a 5 foot or 6 foot fence     Has bitten another dog or person - Please describe:     Flea & Tick control - Type:  Frequency:  Time of month:     Heartworm control - Type:  Frequency:  Time of month: Where does your dog sleep? List brand of food fed and any medical, physical, or other problems we should be aware of. Describe anything that upsets your dog (thunderstorms, another dog near their food, etc.) Let us know anything else about your dog that would assist us in providing the best possible care and most fun while here at Cloud Nine Canines. Veterinarian Information Veterinarian Name: Phone: City: Date of last visit: Policy and Authorization Information The dogs here are accustomed to playing with other dogs; the nature of this kind of environment can present some issues you should be aware of. Just like children, the dogs can play hard and sometimes will get bruised, muscle strains, nicks and scrapes or worse. Every effort is made to keep the “play” from escalating into extreme “rough housing” or worse. I, , hereby certify that my dog(s): : Is in good health and has not been ill with any communicable condition in the last 30 days. Has not harmed or shown aggression or threatening behavior towards any person or any other dog. I have read the policies page and understand the following: I certify that I am the sole owner of the dog or acting on the owners behalf and am authorized to sign this form. I am solely responsible for any harm caused by my dog(s) while my dog(s) is attending Cloud Nine Canines. I release Cloud Nine Canines, its owner, employees and volunteers of any liability arising from my dog(s) attendance and participation. I understand that there is a possibility for injuries, communicable diseases and parasites when dogs play together. I authorize Cloud Nine Canines, at their discretion, to engage the services of a veterinarian if my dog requires care. I agree to be solely responsible for the payment of all medical bills and release Cloud Nine Canines, its owner, employees and volunteers of any responsibility related to such medical care. I authorize Cloud Nine Canines to contact my veterinarian to confirm health, temperament and vaccination records. I agree that prior to my dog leaving Cloud Nine Canines, all charges will be paid in full. _____________________________________________________________ SignatureDate *To be signed and dated before boarding.

Home | Boarding & Daycare | Policies | Gallery | Links | Email Us