PET WALKING APPLICATION

Dog Name: ____________________ Gender: ______________ Birthday/Adoption: ____________ Weight: ________

Breed: _____________________________ Color/Markings: _________________________

Owner Name: ________________________________________ Email Address: _____________________________

Address: _______________________________________________________   Unit/Apt: ______________________

City, State, ZIP: ________________________________________________________________________________

Daytime Phone: __________________________________  Alternate Phone:________________________________

How did you find out about our services?_____________________________________________________________

Contract Only Registration? Y    N

Emergency Contact (Where we can reach you in case of questions or emergencies):

Name: ____________________________________________________ Relationship: ________________________

Phone Number(s): ______________________________________________________________________________

Veterinary Information:

Primary Clinic: ____________________________________ Doctor: ______________________________________

Address: _____________________________________ City, State, ZIP: ___________________________________

Phone Number: _______________________________

Walking Schedule: I would like my pet walked on the following days (indicate the time under each day):

MONDAY                     TUESDAY                      WEDNESDAY                     THURSDAY               

_________                  _________                  _____________                      __________               

FRIDAY                      SATURDAY                       SUNDAY

_________                 _________                         ________

Special Instructions:

You will find my dog (in the yard, in a crate, etc.):_______________________________________________________

Please return my dog to (a particular area of the house, a crate, etc.)_______________________________________

Location of collar & leash: _________________________________  Location of food & treats: _____________________________

Location of any medications: _______________________________

I will provide Dogone Fun! with 2 keys to my home:    Yes                            No

My home is equipped with a security system that disarms with the following code or keystrokes: ______________________________________________________________________

For Office Use:

Key Number: __________________________

Location: ___________________________

Other Important Information:

Does your dog have any medical conditions we should know about (allergies, hip dysplasia, etc.)? _______________

_____________________________________________________________________________________________

Is there anything specific that we should know before we enter your home? _________________________________

_____________________________________________________________________________________________

Does your dog show aggressive behavior when someone approaches? ____________________________________

_____________________________________________________________________________________________

Is your dog leash aggressive? ______________

Dog/Dog ____________         Dog/Person ______________

Does your dog have a gender issue? _______________________________________________________________

Other Instructions:

Administer medication:                       Yes                              No

If yes, medication name & dosage: _____________________________________________________________

Set up gates/close doors: ____________________________________________________________________

Water Plants: ______________________________________________________________________________

Other: ____________________________________________________________________________________

Client Agreement and Release of Liability

I hereby release Wags & Walks., its agents, officers, sub-contractors, employees, animal owners, customers, and potential customers of Wags & Walks from any and all liabilities, financial, and otherwise, for injuries to myself, my dog, or any other property of mine, which arise in any way from services and/or products provided by or as a consequence of my association with Wags & Walks.

I agree to assume all liabilities and responsibilities, financial and otherwise, for the behavior and health of my dog. In consideration of the services rendered by Wags & Walks., I waive any and all claims, actions, or demands of any nature, foreseen or unforeseen, that I may have against Wags & Walks relating to the care, control, health, and/or safety of my dog arising during walking time.

I authorize Wags & Walks. to do whatever they deem necessary for the safety, health, and well-being of my dog while under the care of Wags & Walks, including seeking professional veterinary treatment for my dog.

I understand that Wags & Walks has the right to refuse service to me and/or my dog at any time for any reason. I understand that if my dog has a history of or repeatedly demonstrates aggression or biting of humans or animals, Wags & Walks reserves the right to refuse service. I understand that all bites will be reported to the local authorities as required by law.

I hereby declare to Wags & Walks that I am the legal owner of my dog; that my dog has not been exposed to distemper, rabies, or parvovirus within the past thirty (30) days, that my dog has been inoculated as indicated by records presented.

Payment Requirements

Unless I signed up for the contract only service I must pay at either the initial consultation or the first day of service.

I understand that the hours of operation at Wags & Walks Inc. are 9 a.m.-6 p.m. Monday-Friday and 10 a.m.-4 p.m. Saturday. Sunday closed.

I understand that I will be charged a $25 handling fee for returned checks.

CLIENT SIGNATURE                                                                                                                                                                DATE