Owner's Name* First Last Emergency Contact's Name* First Last Emergency Contact's Phone Number* Pet's Name* Pet's Name* Pet's Age Pet's Sex Pet's Weight Pet's Breed Check-in Date Check-in Time Check-out Date BelongingsIs your pet on a special diet? Yes No Diet Name Last Fed Will you be bringing food? Yes No Feeding Instructions: List Medications / Dosage / Last GivenPersons authorized to pick-up your pet on your behalf: **If any fleas are noticed on Unknown while in our care a CapStar flea preventative will be given. **Resort Service (check all that apply) Doggy Daycare Individual Play Time Bath Nail Trim Board & Train N/A 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
