Owner Information
Owner's First Name Owner's Last Name Cell Phone Email (don't worry, we won't spam you)
Secondary Owner's Name Secondary Owner's Phone
Street Address City State Zip Code
Emergency Contact Name Emergency Contact Phone
How did you hear about us?
Pet Information
Dog's Name Dog's Breed Birthday (if unsure, use best judgement) Weight Color What are you currently feeding your dog?
Sex
Male Female
Spayed/Neutered
Yes No
If not, when do you plan on altering?
Vet Clinic Vet Phone
What service(s) are you interested in? Grooming Boarding Daycare
Owner Agreement
This is a Contract between Puppy’s Playpen, LLC (Pet Care Facility)
and the pet owner set for above whose signatures appear below (hereinafter called Owner)
By checking next to each statement, you're acknowledging that
Puppy’s Playpen is not responsible for any such incidents.
If pet becomes ill or if the state of the animal’s health otherwise requires professional attention, the pet care facility, in its sole discretion, may engage the services of a veterinarian or administer medicine or give other required attention to the animal and the expenses thereof shall be paid by the Owner.
Reservations are REQUIRED for daycare, boarding and grooming. Your pet will be turned away if our facility is at its capacity.
When dogs are participating in daycare/boarding, I understand that dogs play with their mouths and paws which means their teeth and nails. Dog play may involve rolling around and mouthing each other and even in regular normal interactive play, dogs can receive scratches, punctures and other wounds. My dog might get stinky or dirty when playing with other dogs.
I understand that when my dog gets groomed, injuries can occur even when proper grooming procedures are in place and followed. Injuries such as but not limited to razor burn, nicks and cuts.
When my dog is participating in daycare/ boarding, I understand that if my dog causes injury to another dog I am financially responsible to pay any medical expenses. I understand if my dog hurts another dog with the intent to do harm my dog will be asked to not come back to Puppy’s Playpen.
I understand that I am 100% responsible for my dog’s actions when my dog is under my control, and I hold Puppy’s Playpen harmless of liability for any injury my dog may cause to another dog or person while in my control in the lobby, foyer, parking lot and all spaces in between
I understand that it is my responsibility to protect my dog from fleas and ticks and I will keep my dog on a parasite preventative program. If Puppy’s Playpen finds fleas on my dog, I understand that my dog will be removed from play and given a flea bath at my expense.
I understand that my dog might be exposed to a contagious illness such as but not limited to, kennel cough, papilloma, conjunctivitis, GI parasites and bacterium and Puppy’s Playpen will not be held financially responsible. Puppy’s Playpen will quarantine my dog and will call me to pick up my dog if this occurs.
I understand that Puppy’s Playpen is not responsible for any personal items I leave at the facility such as but not limited to bedding, toys, crates, medicine, collars, harnesses, and leashes. If any items are left for longer than 14 days, they will be donated.
I understand that in the event of a life-threatening situation Puppy’s Playpen will take my dog to Blue Pearl or Mission Med Vet. I understand that in the event of a non-life-threatening situation Puppy’s Playpen will take my dog to my vet (within a 10-mile radius) or a closer facility that Puppy’s Playpen uses frequently such as Mission Road Vet Clinic, Nall Hills Vet Clinic, Cherokee Vet Clinic and Prairie Village Vet Clinic. I will be responsible for all medical expenses.
Owner agrees to pay the rate for boarding, daycare or grooming in effect on the date pet is checked out of the pet care facility.
Owner further agrees to pay all costs and charges for special services requested, and all veterinary costs for the said pet while in the care of the pet care facility.
Owner further agrees that the pet shall not leave the pet care facility until all charges are paid to the pet care facility by the owner.
By signing this Contract and leaving his/her pet with the pet care facility, Owner certifies to the accuracy of all information given about said pet. I further understand and agree that in admitting my pet(s) is/are in good health and have not harmed or shown aggressive or threatening behavior toward any person or dog.
The pet care facility shall exercise reasonable care for the pet delivered by the Owner to the pet care facility for boarding, daycare or grooming. I further understand and agree that Puppy’s Playpen, LLC and its staff, will not be liable for any problems which develop, provided reasonable care and precautions are followed, and I hereby release them of any liability of any kind whatsoever arising for my pet’s attendance and participation at the pet care facility. It is expressly agreed by Owner and pet care facility’s liability shall in no event exceed the lesser of the current value of the pet of the same species or the sum of $200.00 per animal. The Owner further agrees to be solely responsible for any and all acts or behavior of said pet while it is in the care of the pet care facility. I further understand and agree that any problems which develop with my pet(s) will be treated and deemed best by staff and volunteers of Puppy’s Playpen, LLC, at their sole discretion, and that I assume full financial responsibility for any and all expenses involved.
Owner specifically represents that he or she is the sole owner of the pet, free and clear of all liens and encumbrances.
Owner specifically represents to pet care facility that the pet has not been exposed to any communicable diseases within the last thirty-day period prior to attending any activity at Puppy’s Playpen.
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 Puppy’s Playpen, LLC.
Owner Digital Signature Date
If you are enrolling your dog for grooming only, stop here & scroll to the very bottom and click submit.
If you are interested in enrolling your dog for daycare/ boarding, please continue to questionnaire
Pet History
Where did you acquire your dog? When did you acquire your dog? Do you have any other pets at home? (If so, explain)
Personality
How do you describe your dog’s energy level? Is your dog comfortable around other people? (If not, explain) Is your dog friendly with other dogs? (If so, explain) Would you consider your dog to be an excessive barker? Is your dog an escape artist? (If so, explain) Would you consider your dog to be a rough player? Would you describe your dog to be an alpha (dominant) or omega (submissive), and why?
Social
Have you ever taken your dog to daycare? (If yes, which one?) Does your dog have separation anxiety? (If yes, explain) Have you ever taken your dog to the dog park? (If so, explain how they “play”)
Medical
Does your dog have any medical conditions? (If so, please list) Has your dog had any past procedures besides spay/neuter? Does your dog have any allergies? (If so, please list) Is your dog on any medications? (If so, please list)
