Owner's Name* First Last Dog's Name* Dog's Age Dog's Weight Spayed/Neutered? Yes No Tell us a little about your dog:Has your dog ever been to another daycamp or boarding facility? Yes No What are your reasons for bringing your dog to daycamp?Is there a person, type of dog, or situation that makes your dog uncomfortable? Yes No Please describe.Has your dog ever shown aggression toward a person or a dog? Yes No Please describe.Can you take food or toys away from your dog without them growling? Yes No Will your dog share toys with other dogs? Yes No Is there an area on your dog where they do NOT like to be touched? Yes No Please describe.Has your dog ever socialized with a group of dogs before? (4 or more) Yes No Please describe.Are there any restrictions that should be placed on your dog's activity? Yes No What restrictions?Does your dog have any allergies or medical conditions? Yes No Please describe.Is there anything else you would like to tell us about your dog?Policies, Procedures and Release Agreement Daycare Requirements: All pets must be spayed/neutered if over 8 months of age; good general health and free of fleas and ticks; not aggressive towards other dogs/people; not protective of toys. Must also be up to date on rabies, distemper, and bordetella vaccines, with a current negative intestinal parasite screen. Aggressive Dogs: I understand that if my dog acts aggressively or shows unacceptable behaviors he/she may be separated from the daycare group and be given individual playtime based upon staff discretion. I understand that an Oak Heart Veterinary Hospital representative will consult with me on ways to address any behavior issue that may arise. Aggressive dogs may be asked not to return to daycare and alternative options will be explored. Photographs: I am aware that photographs taken of my dog participating in daycare may be posted on the Oak Heart Veterinary Hospital website and/or Facebook and Instagram pages. Duty to Disclosure: I have disclosed and will continue to disclose in the future any and all medical or other conditions, including personality issues or concerns that may affect my dog’s ability to participate in daycare. Acceptance and Acknowledgement of Daycare Participation Risk: I understand that there are inherent and potential risks involved in interactions between humans and dogs, as well as between dogs and other dogs. These interactions could result in injury and I understand that Oak Heart Veterinary Hospital will take appropriate medical action in such situations to ensure the safety and well-being of persons or dogs involved. I fully accept and assume responsibility for all risks as a result of my dog’s participation in daycare. In case we are unable to contact you at the listed numbers, you consent to medical care and possible transportation to an emergency facility if deemed necessary by our staff. You will accept any financial responsibility associated with treatment.* Yes No Owner's Signature* Date* MM slash DD slash YYYY CAPTCHA
