Pembroke Animal Hospital Doggie Daycare Registration If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Pet's Name * Your Name * Regular Vet * Breed(or best guess) * Coat Color Pet's Birthday(or best guess) * Is your dog Spayed/Neutered? * YesNoUnknown When did you get your dog? * How old was he/she at the time? * If adopted, what do you know of their history? Is your dog a digger, jumper, climber or escape artist? * YesNoUnknown If yes, please explain: Has your dog ever been in a daycare/multiple dog setting before? * YesNo If yes, please describe Does your dog have any fears or dislikes of any other dogs, people, or objects? * YesNoUnknown If yes, please describe in detail. Has your dog ever been aggressive towards other dogs or people? * YesNoUnknown If yes, please describe in detail. Does your dog guard or get aggressive over food, treats or toys? * YesNoUnknown If yes, please describe in detail. Anything else you'd like to share with us about your dog? Before you enroll your dog, it’s important to know that not all dogs enjoy daycare. Dogs in the wild don’t play in large groups, and while many domestic dogs love daycare, it’s important to understand that your dog might not. Dogs can’t tell you that they’re not having fun, so if we notice signs of distress, aggression or unhappiness we will recommend that your dog come less often to daycare, or perhaps not come at all. This is not a reflection of your dog’s “goodness” or likability. We don’t want to create a situation that puts the physical and emotional well-being of your dog, other dogs, and our staff at risk. What makes a dog a good candidate for daycare? Dogs should be well socialized and enjoy meeting new dogs and people Dogs should be in good physical health Dogs should know basic commands such as their name, come, and sit. Dogs should be comfortable in new environments and being away from their owners What makes them a bad candidate? Dogs over 6-8 months of age with little to no socialization or “life exposure”. It’s a lot to ask a dog to be able to come into a new environment, engage with new people and dogs, and just “go play”. Dogs with a history of aggression toward people or other dogs Dogs with physical problems or ailments such as arthritis, seizures, vomiting or diarrhea DAYCARE HOURS MONDAY – FRIDAY 7:00AM TO 5:30PM, closed holidays, may close in the event of severe weather. DAYCARE RATES FULL DAY (5 HOURS OR MORE)………………………...$20 HALF DAY (LESS THAN 5 HOURS)……………………...$13 I, the undersigned, entrust Pembroke Animal Hospital with the care of <animal> for doggie daycare. I acknowledge and understand that there are certain risks involved in participating in daycare and in owning, caring for, handling and being in the presence of dogs, including but not limited to injuries to people, property and animals resulting from dog fights, dog bites to humans or other dogs and the transmission of disease. (please check each line) I hereby accept those risks for myself and for my dog and agree that Pembroke Animal Hospital shall not be held responsible for any injuries suffered by myself or my dog as a result of any such incidents at Pembroke Animal Hospital. I as the pet owner agree to be solely responsible for any and all acts or behavior of my pet while in the care of Pembroke Animal Hospital. I hereby release and agree to indemnify and hold harmless Pembroke Animal Hospital from any liability arising from my dog’s attendance and participation in doggie daycare. * I agree to keep my dog up to date on all required vaccines (Distemper, Rabies, and Kennel Cough – influenza, Lyme and leptospirosis recommended but not required) and to administer monthly flea/tick and heartworm/intestinal parasite prevention. I also understand that to continue in daycare after the age of 6 months, my dog will be required to be spayed or neutered. Dogs not up to date on their vaccines/intestinal parasite screens will not be admitted to daycare. * I give Pembroke Animal Hospital permission to provide medical care for my pet should he/she become ill or injured while attending doggie daycare. I understand that I will be responsible for the cost of treatment and agree to pay any charges incurred at the time of pickup. I also understand that should my pet be found to have fleas and/or ticks, he or she will be treated for them at my expense. * Photographs, videotape or digital recordings are taken of the facility, dogs, and staff on a regular basis for, among other things, use in advertising by Pembroke Animal Hospital. I acknowledge that all such images are the property of Pembroke Animal Hospital and I give Pembroke Animal Hospital my permission, without compensation to me, to use, reproduce and alter the images, in print or electronic format (including on the internet/social media), either alone or in combination with other images, text and graphics. * I understand that all daycare dogs must be picked up by 5:30. I am aware that if I am unable to pick up my dog by closing, he/she will be boarded overnight at my expense. * Please type name to sign: * Emergency Contact Number: * Email *