Pet Info Form

state law requires all daycare clients to submit a yearly info form.
This allows us to provide emergency care to your pet if necessary. thank you for your compliance!

* Indicates required field

(Human) Client's Name *

First

Last

Phone Number (Primary) *

Phone Number (Secondary) *

Email Address: *

Home Address: *

Emergency Contact Name: *

Emergency Contact Phone Number: *

Names of persons authorized to pick up your dog from daycare: *

Dog's Name *

Dog's Breed or Mix *

Dog's Birthdate (estimated is fine) *

Feeding Instructions: (Name of food & amount given) *

Is your dog on any medication other than flea / tick / heartworm prevention? If so, please list name of medication and dosage: *

Dog's Veterinarian *

Please list any allergies or health conditions your dog has: *

Please list any other important information: (Human family allergies to food / scents / etc.) *

Please familiarize yourself with our 2020 policies and check the boxes below: *

I must cancel same-day daycare or dog walk by 7:30am to avoid being charged I must cancel same-day shuttle service by 6:30am to avoid being charged Go Play! requires a 2-week written notice of permanent schedule changes to avoid being charged in full If my dog receives any vaccinations they will stay out of daycare for a period of five days after. Failure to comply with this policy will result in immediate dismissal from Go Play! I have received Go Play!'s schedule changes for 2020 I understand there is a late fee (starting at $15.00) for dogs picked up after 6pm I understand there will be a late fee for all bills not paid when services are completed I understand that if I cancel daycare or dog walking services frequently, I am in danger of being removed from the permanent schedule with a 2-week notice provided by Go Play! I understand if I am taking a leave of absence from daycare (more than 2 consecutive weeks in a row) I am responsible to pay 50% to hold my permanent spot

Would you like to be on the wait list for any schedule openings? If so, please list the day & service you'd like to be on the wait list for: *

By checking this box and submitting this form, I agree all the information I have shared is accurate. I also give Go Play! permission to contact my veterinarian to verify my dog is current on the required vaccinations and fecal flotation needed to participate in daycare. Go Play! (hereafter referred to as Company) is entrusted to use best judgement in caring for Client's animals. In the event of an emergency, inclement weather, natural disaster, or other circumstances beyond all control prohibit Company from caring for animals, Company will be held harmless for related consequences. Company has all rights to refuse services due to inclement weather or other dangerous circumstances. Client is responsible for injury to persons, animals, property, death, or injury to animals named in this contract. Client agrees to pay any veterinary costs to animals during time they are being cared for by Company. If animals become ill, the Company may engage the services of a veterinarian to administer medicine or provide medical care to animals. Dogs are prohibited from daycare for five days after receiving a vaccination. If Company or representative is bitten, injured, or exposed to any disease or ailment received from Client's animals it is the Client's responsibility to pay all costs and damages incurred. Company has the right to refuse services to any animals for any reason. Company agrees to use Client's equipment for animals and is not responsible for faulty, damaged, or damages to equipment. Client understands pet grooming includes the use of sharp tools and clippers and the difficulty of using those tools on live animals. Client understands there is a risk of clipper / brush irritation, eye, ear, and skin irritations due to a matted, dirty, or unkept coat and grooming. Company is released of all faults when providing grooming services. If any circumstances arise, leading to additional charges upon an agreed price, Client is responsible for additional charges. Client agrees to pay a late fee for all payments not received upon completion of services. Client understands all cancellation policies and agrees to provide a 2-week written notice to any changes in Client's permanent schedule changes to avoid being billed in full for the 2 weeks. Animals picked up after 6pm incur a late fee starting at $15.00. Same-day shuttle service must be cancelled by 6:30am, same-day Daycare and Dog Walking must be cancelled by 7:30am to avoid being charged in full. Dogs over 6 months old may be charged a clean-up fee (starting at $5.00) for dogs who have accidents in our facility or in the shuttle. If you cancel daycare services frequently, you may be removed from the permanent schedule with a 2-week notice from Company. If you are taking an extended leave from daycare or dog walking services (more than 2 consecutive weeks in a row), Client must pay 50% of charges to hold spot. Company will have printed copy of this contract available to Client. This is a valid and binding contract for all services provided by Company. *

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state law requires all daycare clients to submit a yearly info form.This allows us to provide emergency care to your pet if necessary. thank you for your compliance!

state law requires all daycare clients to submit a yearly info form.
This allows us to provide emergency care to your pet if necessary. thank you for your compliance!