Application and Waiver Forms

 

These forms must be filled out in full, dated, signed, and approved by the daycare prior to your dog’s first booking.

 

Dog Information:

 

Dog’s Name: 

Breed:            

Colours:         

Birthdate (year): 

Sex:  Male          Female      

City License #:     

Microchip #:       

Tattoo:              

 

 

Owner Information:

​

Owner Name(s): 

Address: 

City:                 

Postal Code: 

Home Phone:                     

Work Phone: 

Cell Phone:                   

Email: 

​

Authorised Persons:

​

The following are the names of individuals that have your permission to pick up your dog from Dachshund Haven. You understand that once dogs are released into the care of authorized persons or individuals that Dachshund Haven is no longer responsible for the well-being of your pet.

 

Authorised Individuals:

​

Name: 

Name:

Name:
 

Emergency Information:

 

 Emergency Contact Name:

Phone:

(h):

(c):

(w):

 

Primary Veterinary Clinic:

Clinic Phone:

Preferred Veterinarian if any:

Phone: 

(h): 

(c):

(w):

Clinic Address:  

 

 

Vaccinations

All dogs must have all vaccinations up to date.  Owners must submit written
proof of all vaccinations including Kennel Cough. We strongly recommend all

dogs be on a flea/tick/lice prevention program .

 

​

​

Care

​

Is your dog being fed at daycare? Yes                      No 

If yes, please specify the time and amount of food. You are responsible for supplying your dog’s food:

 

​

​

​

​

Medications: 

​

​

​

​

​

​

Allergies:        

​

​

​

​

​

​

Physical limitations or health problems: 

​

​

​

​

​

​

​

*Please note, if your dog has been ill with a communicable or potentially communicable disease within the past 30 days a health clearance signed by a licensed veterinarian must be received before your dog can attend daycare. Please do not bring ill (vomiting, diarrhea, eye/ear infections) or injured (sore, limping etc) dogs to daycare.

​

​

Pet Behaviour Profile:

​

​

How long have you owned your dog?         

Where did you get your dog? 

Has your dog been to a daycare before?                      Yes            No 

Is your dog comfortable with strangers?                     Yes            No 

Does your dog get along well with larger dogs?        Yes            No 

Does your dog get along well with smaller dogs?      Yes           No 

Does your dog get along well with puppies?               Yes           No 

If you answered ‘no’ to any of the last four (4) questions please describe: 

​

​

​

​

​

Is your dog sensitive to touch on any part of their body?

​

​

​

​

​

Has your dog had any formal obedience training? : Yes          No 

If yes, what type, where and when? 

​

​

​

​

​

​

Potty command? :      

If your dog has any special commands you would like used, write them here:

​

​

​

​

​

Has your dog ever…? (If yes, please describe)

Growled at someone: 

​

​

​

​

​

Bitten or snapped at a person: 

​

​

​

​

​

Reacted negatively when food or toys are taken: 

​

​

​

​

​

Been in a fight with another dog: 

​

​

 

​

​

​

​

Does your dog have any problems in the following areas? Check all that apply.

 

Mouthiness on hands or clothing 

House training 

Excessive Barking 

Fence Jumping

Digging 

Coprophagia (feces eating) 

Destructive chewing 

Separation Anxiety 

Jumping Up 

 

 

Daycare Rules and regulations:

 

• We accept dogs of all ages. Puppies must be over 12 weeks and on a vaccination program. Puppies or shelter dogs must have been in the home for at least two weeks prior to attending daycare.

• All dogs over the age of 6 months must be spayed or neutered

• All dogs require up to date vaccinations for rabies, DHLPP, and bordetella. Proof of vaccination or titer testing is required.

• Dogs that are currently ill or injured are not permitted at daycare. Dogs who have recovered from a communicable illness within the past 30 days must provide veterinary clearance to return to daycare. Owners certify by signing this application that their dog is in good health.

• If your dog incurs veterinary bills during their stay at daycare you, the legal owner of the animal, must pay those bills at time of pickup. Dachshund Haven reserves the right to seek veterinary care for your dog at its discretion.

• All dogs must be non-aggressive and not food or toy possessive. Owners certify by signing this application that their dog has no history of threatening or harming any person or animal.

• We reserve the right to refuse any dog for any reason at any time.

• Pick-ups must be completed by 6:00 PM. Late fees for late pick-ups do apply at a rate of $15.00 for every 15 minutes past 6:00 PM. No exceptions.

• Daycare passes have no cash value and are non-refundable. No exceptions.

 

 

 Waiver and Agreement

 

1. I hereby represent that I am the legal owner of the dog(s) described above to use the services provided by Dachshund Haven.

 

2. I hereby waive and release Dachshund Haven, it’s employees, directors, owners and agents from any and all liability which my dog(s) may suffer, including specifically, but not without limitation, any injury or damage whatsoever arising from the dog(s) attendance and participation of services including the pond provided by Dachshund Haven.

 

3. I hereby agree to indemnify and hold harmless Dachshund Haven; it’s employees, directors, owners and agents from any and all claims by any member of my family or any other person accompanying me to a function of Dachshund Haven, or while attending the premises thereof, as a result of any action by any dog.

 

4. I hereby represent that my dog(s) is of good health and has not been ill with any known contagious diseases within the past 30 days.

 

5. I recognize that the health of the dog(s) is the owner’s responsibility. I hereby represent that all required vaccinations (rabies, bordetella, distemper and parvovirus) are up to date. I will also continue to ensure that the required vaccinations will be kept up to date for as long as my dog(s) attends Dog’s Day Pet Care.  In addition, I hereby represent that my dogs have flea/tick preventative treatments applied regularly.

 

6. I further understand and agree that in admitting my dog(s), Dachshund Haven has relied on my representation that my dog(s) is in good health and has not harmed, shown aggression or threatening behavior towards any other person or any other dog.

 

7. I further understand and agree that Dachshund Haven and their caregivers will not be held liable for any problems that might develop with my dog(s) including, but not limited to sickness, disease, injury, running away and death, provided that reasonable care and precautions are followed.

 

8. I understand and agree that any problem that develops with my dog(s) will be treated as deemed best by the care-givers of Dachshund Haven at their sole discretion and that I assume full financial responsibility for any and all expenses incurred.

 

9. Dachshund Haven fees and packages are non-refundable and non-transferable.

 

10. I agree that my dog(s) may be videotaped, photographed and or recorded. Dachshund Haven shall be the exclusive owner to the results and all proceeds of such media.

 

11. Dachshund Haven reserves the right to permanently remove a dog from care at any time to ensure the safety of other dogs as well as staff. 

 

12. I understand that the rules above apply to any dog(s) of mine attending daycare.

 

 

Signature:______________________________ 

Date:___________________                

Print name:_____________________________