Doggie Day Care Registration

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Owner's Information:

Full Name:

Name

Address:

Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
PhoneHome
PhoneCell
PhoneWork

Second Owner Information:

You will be listed as the Primary Owner on the account. Please list anyone who is also an owner here.

Second Owner Full Name: 

First Name
Last Name

Second Owner Phone:

Phone Number

Emergency Contact Information:

Someone who we would contact in an emergency if we couldn't reach either Owner.

Emergency Contact Full Name:

First Name
Last Name

Emergency Contact Phone:

Phone Number

Authorized to Pickup: 

(List any additional people authorized to pickup your dog)

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Which Pet Laundry services do you plan to use?

Dog Information: 

Dog's registered under one account must be from the same family (household) and live together.


First dog information:

Dog's Name
Color(s)
Sex
Spayed/Neutered?
Breed
Weight
Birth Date
Where did you get your dog?
How long have you had your dog?
Has your dog been to any other Boarding, Daycare or Grooming facilities in the past 30 days?
If Yes, please let us know where the facilities were located (Name of Facility, City, State)
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Date your dog was last at the facility:
Brand and type of food currently fed:
Upload Headshot
Upload vaccination records

Second Dog Information: 

Dog's registered under one account must be from the same family (household) and live together.

Dog's Name
Color(s)
Sex
Spayed/Neutered?
Breed
Weight
Birth Date
Where did you get your dog?
How long have you had your dog?
Has your dog been to any other Boarding, Daycare or Grooming facilities in the past 30 days?
If Yes, please let us know where the facilities were located (Name of Facility, City, State)
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Date your dog was last at the facility:
Brand and type of food currently fed:
Upload Headshot
Upload vaccination records

Veterinarian Information:

Hospital Name:
Veterinarian Name:
Vet Phone Number:
Last visitapprox date
Flea Control: (All dogs must be on a routine flea control program)

Heartworm Preventative: (All dogs must be on a monthly heartworm prevenative and be heartworm negative)

Describe any allergies or health issues
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Proof of the following must be provided in writing before any dog is permitted into our facility:

  • RABIES - Vaccine Every 3 years
  • DHLP or DHLPP - Vaccine OR Titer Test results Every 3 years
  • BORDATELLA - Vaccine every 1 year
  • CANINE INFLUENZA - Vaccine every 1 year
By filling in the signature box (to the right) with your name and pressing the “Register” button at the bottom of this page, you agree to the terms & conditions below:

Contract

This is a contract between Pet Laundry, LLC (hereinafter referred to as "Facility") and the pet owner whose signature appears above (hereinafter referred to as "Owner").

1. Owner certifies the accuracy of all information Owner has conveyed about Owner's pet to the Facility.

2. Owner specifically represents to the Facility that Owner's pet has not been exposed to rabies, distemper or any other contagious or communicable disease within a thirty day period prior to being left for boarding, day care or grooming. Owner agrees to notify Facility of any exposure to any virus, infection or other transferable illness and will not bring pet to Facility until pet is symptom free for a reasonable period to be determined by pet's veterinarian or until written approval is obtained from a veterinarian. Owner further agrees not to bring pet to Facility if pet is exhibiting any signs of illness that may be harmful to the other dogs in attendance, such as: vomiting, diarrhea, coughing, extreme lethargy, etc. without first obtaining approval from the Facility.

3. The Facility shall exercise reasonable care for Owner's pet while Owner's pet is in the Facility's custody. The owner recognizes the potential risks involved with group play/dog day care, boarding, and grooming due to the unpredictable nature of dogs.

4. Facility reserves the right to change the level or type of daycare/boarding or remove the pet from group play, if in its sole discretion it is believed necessary to ensure the safety of the pet, other dogs or its employees.

5. Owner specifically represents that he or she is the sole owner of the pet (which Owner is delivering to the Facility pursuant to this Contract), free and clear of all liens and encumbrances.

6. Owner represents to the Facility that all credit card information Owner has provided to the Facility is accurate. Owner further represents that all information Owner has provided to the Facility about Owner is accurate, and that Owner is over 21 years of age.

7. Owner agrees to pay the rate for any and all services in effect on the date Owner checks Owner's pet into the Facility as listed in the Facility.

8. Owner agrees that if Owner's pet becomes ill or if the state of the pet's health otherwise requires professional attention, the Facility, in its sole discretion, may engage the services of a veterinarian or administer medicine or give other requisite attention to the pet and the expenses thereof shall be paid by the Owner. Owner gives consent to the Facility to act in the Owner's behalf in obtaining emergency veterinary care at Owner's expense if deemed necessary by the Facility or any of its employees. Owner agrees to indemnify and holds the Facility and its employees harmless from said expenses.

9. Owner agrees to pay all charges for special services requested, all veterinary costs for pet during the time said pet is in the care of the Facility, and all fees incurred by Owner through Owner's failure to comply with the Facility's Cancellation Policy.

10. Owner agrees that the Facility may collect amounts owed by Owner due to Owner's failure to comply with the Facility's Cancellation Policy by charging such amounts to Owner's credit card (data concerning which Owner has supplied to the Facility). All other charges incurred by Owner shall be payable upon pick-up of Owner's pet, or when billed by Facility at address of Owner listed in this Contract. Owner further agrees that the Facility shall have the right to refuse to release Owner's pet to Owner until Owner has paid all charges due from Owner to the Facility.

11. Owner assumes any and all expenses or liability for injuries that Owner's pet may inflict upon any human or other pet while in the Facility. Owner agrees to indemnify and holds the Facility and its employees harmless from any and all expenses and liability incurred as a result of injuries Owner's pet inflicts upon any human or other pet while in the Facility.

12. Owner hereby grants the Facility the right to take photographs of Owner's pet while the Facility is caring for Owner's pet, and to post or reproduce any and all photographs taken (as well as Owner's pet's name) on or in, without limitation, the Facility's web site, promotional materials and merchandise, without becoming liable to the Owner (or the Owner's pet) for any royalty payment of any kind. Owner hereby releases, covenants not to sue, and forever discharges the facility of and from any and all claims, demands, rights, and causes of action of whatever kind or nature including, but not limited to, appropriation of the picture or name of owner’s pet for commercial advantage, publication of facts placing the owner and/or Owner’s pet in a false light, and public disclosure of private facts about the owner and/or Owner’s pet, arising out of or relating to any photographing of or use of photographs or video of Owner’s pet pursuant to the authority Owner has granted the Facility in the sentence immediately preceding this sentence.

13. Owner expressly agrees that facility's liability shall in no event exceed the current chattel value of a pet of the same species as the pet delivered by owner to the facility pursuant to this contract.

14. This Contract contains the entire agreement between the parties. All terms and conditions of this Contract shall be binding on the heirs, administrators, personal representatives and assigns of the Owner and the Facility.

15. Any controversy or claim arising out of or relating to this Contract, or the breach thereof, or as the result of any claim or controversy involving the alleged negligence by any party to this Contract, shall be settled by arbitration in accordance with the rules of the American Arbitration Association, and judgment upon the award rendered by an arbitrator may be entered in any court having jurisdiction thereof. The arbitrator shall, as part of his/her award, determine an award to the prevailing party of the costs of such arbitration and reasonable attorney's fees of the prevailing party.

* Owner may, at Owner's option, enter into a non-electronic contract with the Facility. If Owner desires to enter into a non-electronic version of this contract with the Facility, Owner should notify the Facility of such desire and Owner should not attach Owner's "electronic" signature to this Contract

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