EmailMe Form - Tails of Success Dog Daycare Information Form

Name (owner #1)

First Last

Name (owner #2)

First Last

Phone *

### - ### - ####

Phone

### - ### - ####

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Email (owner #1) *

Email (owner #2)

How did you hear of us? *

Emergency Contact (name and phone) if you cannot be reached

Dog's Name

Breed *

Age

Date of Birth (approximate is okay) *

Gender *

Male, neutered

Male, unneutered

Female, spayed

Female, unspayed

If not yet spayed/neutered, please provide approximate expected date of surgery:

Color *

Weight *

Vet Hospital

How long have you had this dog?

Brand of food fed at home

Food Allergies? *

I give permission for my dog to receive treats, chews, and stuffed Kongs during daycare: *

Yes

No

Yes, but please see restrictions below

Restrictions or special considerations for treats at daycare:

For my Daycare First Day Reservation: *

I will call to schedule

My day has been booked via phone already

Main reason you plan to enroll your dog in daycare? *

Which Daycare Program would you like to join? *

VIP Daycare

Puppy Club (ages 8w-7m)

How many days per week would you like to attend? *

Which days would you prefer to attend? *

Has your dog attended daycare or other group play before?
If so, where, how often and how long ago?

How does your dog respond to meeting new dogs? *

Does your dog have any sensitive areas on his/her body,
or concerns about being touched or led by the collar? *

Does your dog have any physical limitations or special needs?

How does your dog react to strangers coming into the house or yard?

Has your dog ever bitten a person? *

Yes

No

Almost

If yes or almost, please explain:

Are there any types of people your dog does not like?

Has your dog ever bitten another dog? *

Yes

No

Almost

If yes or almost, please explain:

Are there any types of dogs your dog does not like?

Is your dog possessive with food, toys, or items against other dogs or people? *

Yes, food only

Yes, toys only

Yes, both food & toys

No

If yes, please explain:

Is there any reason you are concerned that your dog may not do well at their daycare interview? *

Is there anything else you would like the daycare staff to know about your dog?

Daycare Interview Process

Your dog will be dropped off in the morning and spend the day at daycare, meeting new friends and slowly integrating into the playgroup over the course of the day.

If your dog does well during their first day, they will be officially accepted into our daycare program and eligible to purchase packages at the discounted monthly rate.

I represent and warrant to Tails of Success that (a) the dog is current on vaccinations as recommended by my veterinarian, (b) the dog is free of all fleas, ticks, worms and other parasites, (c) the dog has no current illness or injury, (d) the dog has not bitten or exhibited other aggressive behavior towards any person or animal, and (e) all information given about the dog is accurate and complete. INITIAL: *

I recognize and accept the possible risks involved in participating in daycare and related services, including but not limited to cuts, scratches, scrapes, pulled or torn ligaments/tendons, bites, punctures, communicable illness, escape and death. I also accept full legal and financial responsibility for any damage or injury to persons, property or animals arising out of my dog’s participation in daycare or other use of the facility. INITIAL: *

I understand that all Daycare reservations must be made in advance and all days must be paid in full at the time of reservation.

We encourage all members to sign up for our auto-pay system, which will renew your daycare package automatically the first of each month.

If you choose to opt-out of auto-pay, you MUST contact the office prior to the first day of each month to renew your daycare membership and reserve your days.
INITIAL: *

Daycare packages reserve me a guaranteed space on the days of the week that I have selected, and does not guarantee a specific number of days of attendance. Monthly dues are the same even if I need to miss a day of daycare, and make up days may be available as space permits. INITIAL: *

I understand that I am financially responsible for all services used and days of daycare attendance. If I incur a past-due balances for services used, I authorize Tails of Success to run the entire past-due balance on my card on file. INITIAL: *