Central Park Dog Daycare Enrollment Application Owner Information Primary Owner Name___________________________________________________________ Address __________________________ City ____________________ Zip Code ___________ Home Phone (____)______________ Work (____)______________ Cell (____) _____________ Email address _________________________________________________________________ Secondary Owner Name ________________________________________________________ Address ____________________________ City _________________ Zip Code ____________ Home Phone (____)______________ Work (____)_______________ Cell (____)_____________ Email address _________________________________________________________________ Emergency Contact (if other than owner) Name(s) ________________________________ Relationship ____________________________ Home Phone (____)______________ Work (____)______________ Cell (____)______________ Authorized to pick-up and drop-off your dogs: Name(s) _____________________ Relationship _______________ Phone (____)_____________ Name(s) _____________________ Relationship _______________ Phone (____)_______________ Help Us Serve You Better How did you hear about us? ❑ Drive-by ❑ Website/Internet ❑ Yelp ❑ Google maps ❑ Dog Park ❑ Referral from: __________________ (referrals receive a free day of daycare) ❑ Other: ___________ What is the primary reason for enrolling your dog in daycare? ❑ Separation Anxiety / Destroys Home ❑ Work long hours ❑ Loves to play with other dogs ❑ Other: _____________________________ Veterinary Information Veterinarian _____________________________________________ Address ____________________________________________ Phone (___)_________________ **Documentation from veterinarian of current vaccinations (Rabies, DHLPPC, Bordetella) is required** 5420 N Classen Blvd Oklahoma City, OK 73118 | (405) 858-2275 | (405) 858-2277 fax | [email protected] Central Park Dog Daycare Enrollment Application Pet Information (Please complete one page for each pet.) Name ____________________________ Age/Birth Date ________________ ❑ Female ❑ Male Breed_______________________ Color_______________ Weight______ ❑ Spayed ❑ Neutered Health History Flea/Tick Prevention Type/Brand _________________________ Date last applied ____/____/____ Health conditions/Allergies _________________________________________________________ Does your dog have any overly sensitive areas on his body? _______________________________ Medications (Please list all medications) Name _________________ Frequency_________________ Quantity_________________ Name _________________ Frequency_________________ Quantity_________________ Feeding instructions for lunch/boarding: (Qty/Brand/Time of day)____________________________ Behavior Profile Yes No Unsure Notes Aggression Towards Dogs Aggression Towards People Excessive Barking Excessive Chewing Toy Possessive Jumping/Climbing on Fences Jumping On People Shares Toys Well Submissive Towards Dogs Submissive Towards People Likes To Dig Eats Stool Plays Rough Additional Information How long have you owned your dog? ________________ Is your dog housebroken? ___________________________ Where did you get him? (breeder/shelter,etc)____________________________________________________________ What kinds of toys and games does your dog prefer? _____________________________________________________ Has your dog ever seriously bitten either a dog or person? _________________________________________________ Is there anything that tends to frighten your dog? ________________________________________________________ Does your dog prefer any specific breeds, sexes, or sizes of dogs? __________________________________________ Has your dog had any formal obedience training? What level? ______________________________________________ How frequently does your dog socialize? (daycare/dog park) _______________________________________________ Please rate your dog’s energy level. 1-very calm to 10-very active ___________________________________________ 5420 N Classen Blvd Oklahoma City, OK 73118 | (405) 858-2275 | (405) 858-2277 fax | [email protected] Central Park Dog Daycare Enrollment Application Client Agreement Please read and initial each line below: ________I acknowledge and understand that there are certain risks involved in participating in group socialization of dogs, including, but not limited to broken nails, abrasions and cuts, raw paw, dog fights, dog bites to humans or other dogs as well as the transmission of communicable illnesses, such as canine cough, puppy warts and/or parasites. ________I further understand that any problems with my dog, behavioral, medical or otherwise, will be treated at the staff’s discretion. ________ I assume full financial responsibility and all liability for any and all expenses in regards to the behavior and health of my dog. ________If my dog becomes ill or injured, Central Park shall have the right to call a veterinarian of their choice; or to administer medicine or give other advisable attention, within their judgment, and such expenses, being reasonable in amount, shall be paid promptly by me, the owner of the dog. ________I understand that I am solely financially responsible for any damage to the property of Central Park Dog Daycare caused by my dog(s) while under their care. ________I agree that in admitting my dog(s) to Central Park, they have relied on my representation that my dog(s) is/are in good health and have not harmed or shown aggressive or threatening behavior towards any person or other dog. ________If my dog cannot safely adapt to the group daycare environment, Central Park shall have the right to place my dog in a traditional kennel of their choice. ________All dogs are subject to a temperament test upon enrollment. Temperament tests are a fee of $15 per dog. ________I understand that reservations must be canceled no later than 72 hours prior to the day of the reservation. I will be subject to applicable charges if I fail to do so. ________I understand that holiday boarding reservations require a two night non-refundable deposit per dog, and that reservations must be canceled 72 hours prior to the day of the reservation to avoid forfeiture of the deposit. ________I understand that I will be charged a late fee for picking my dog up after hours. Late charge for after- hours pick-up is $20 per dog and must be scheduled ahead of time and pre-paid. ________I understand that I will be charged an unscheduled boarding fee of $75 per dog, per night, for any dog that is left past 7pm without prior reservations. (In addition to all daycare fees.) ________I give my permission for images and likenesses of my dog to be used on the Internet, in social media and in publications or promotions. By signing below, I am acknowledging that I have read, understand and agree with the above. Signature: ____________________________________ Date: _____________________________ 5420 N Classen Blvd Oklahoma City, OK 73118 | (405) 858-2275 | (405) 858-2277 fax | [email protected] Central Park Dog Daycare Enrollment Application Program Agreement for Day Training - Board and Train - Private Lessons Pet Information (Please complete one page for each pet.) Name ____________________________ Age/Birth Date ________________ ❑ Female ❑ Male Breed __________________________ Color _______________ Weight _____ ❑ Spayed ❑ Neutered Have you owned this breed before? ❑Yes ❑No Dog is Usually ❑ Indoor ❑ Outdoor ❑ Indoor/Outdoor Dog is usually ❑ Supervised ❑ Unsupervised ❑ Kenneled ❑ Fenced Has your dog bitten any people? ❑Yes ❑No ❑Dates __________ ❑Details ____________________ Has your dog bitten another animal? ❑Yes ❑No ❑Dates _______ ❑Details ____________________ Training Needs Main behavior issue _____________________________________________________________________ Steps taken so far _______________________________________________________________________ Commands dog knows ___________________________________________________________________ Changes coinciding with behavior ❑ New home ❑ New pet ❑ New baby ❑ Marriage ❑ Divorce Training Program Type _____ Day Training (4 weeks) Mon/Wed/Fri: $1295.00 _____ Puppy Program Add-On (+1 week): +$300.00 _____ Board & Train (2 weeks) begins on Monday: $1595.00 _____ Package of 5 private lessons at our facility: $495.00 _____ Package of 8 private lessons at our facility: $775.00 _____ Package of 5 offsite private lessons: $620.00 _____ Package of 8 offsite private lessons: $975.00 5420 N Classen Blvd Oklahoma City, OK 73118 | (405) 858-2275 | (405) 858-2277 fax | [email protected] Central Park Dog Daycare Enrollment Application Training Agreement Training. Both the dog and the owner will receive the training indicated in this Agreement. The dog will be trained to perform as shown by demonstration at the conclusion of the boarding/day/private lesson training. Included in the boarding/day training program shall be follow up training sessions with the owner following the dog’s boarding/day training. The owner understands and agrees that they have responsibility to cooperate fully in completing the owner training sessions, and that the trainer cannot and does not assume or accept responsibility for the behavior or performance of the dog after it has been returned to the owner. The dog is welcome to drop in for two refresher visits during regular daycare visits in order for the trainer to reinforce any specific area of training. *Occasionally, some training activities will take place in the facility parking lot or offsite in order to expose