Client Information
Name
 Date
Street
 City, State, Zip
Phone (Home)
 Phone (Work)
Phone (Mobile)
E-Mail Address
 Dog’s Name
Dog’s Breed
Veterinarian Information
Vet Name
 Phone
Street
 City, State, Zip
Shot Record (date given)
DHLPP
 Rabies
Bordatella
 Spayed/Neutered
Areas of Interest?
Day Camp Boarding Grooming Training
How did you hear about DogDayz?
First visit is a trial visit only – all dogs will be evaluated on an individual bases for acceptance.
With signature below you are authorizing DogDayz, LLC to take your dog to a veterinarian for medical attention should your dog need medical attention during their stay at DogDayz, LLC and accepting responsibility for veterinary cost incurred.

DogDayz, LLC is not held liable if the pet escapes, injures itself or dies during the stay. Reasonable care will be given at all times.

*** Please Note: This contract is legal and binding ***
Signature:
Enter name and click 'submit' to email. Or print, sign and fax to 317-774-8185

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