CubbysCanine

Name*

First Name

Last Name

Email*

Phone*

Pet Name(s)*

What service are you interested in?*

Daycare Grooming Training

For daycare I am interested in*

1 day/month 1 day/week 2 to 3 days/week 4 days/week

Has your dog attended daycare in the past:*

Yes No

Cubby’s Canine Castle Attendance Agreement

Cubby’s Canine Castle, Inc. (Cubby’s) agrees to exercise due diligence and reasonable care for all attendees and maintain a clean and safe environment. The Client authorizes Cubby’s and its representatives to do whatever they deem necessary for the safety, health and well-being of the Client’s dog while under the care of Cubby’s. The Client agrees to follow all rules, regulations and policies as detailed in the Attendance Agreement.

Cubby’s Canine Castle attendance requirements are as follows:

1. All dogs over the age of 7 months must be spayed or neutered

2. All dogs must be over the age of 4 months

3. All dogs must be up to date on Rabies, DHLPP and Bordetella vaccinations and have a negative tested fecal sample annually

4. All dogs must have a current PA Dog License

5. All dogs must be on Flea/Tick Preventative

6. All dogs must be on Heartworm Preventative

7. All dogs must pass behavioral/temperament evaluation conducted by Cubby’s staff

The Client shall provide copies of all up to date vaccination records prior to enrolling and will provide updated vaccination records after any future veterinary appointments to ensure Cubby’s Canine

Castle has up to date records for the dog. Cubby’s reserves the right to modify attendance requirements at any time. In addition, Cubby’s reserves the right to refuse attendance to any dog if deemed an inappropriate fit for the doggie daycare environment.

Cubby’s Canine Castle daycare hours of operation are Monday through Friday, 6:45 AM to 7:00 PM, Saturday 8:00 AM to 6:00 PM and Sunday from 9:00 AM to Noon. Pick ups and drop offs are allowed at any time within those operating hours, Sunday is limited to boarding pick up and drop off only. The Client agrees that any dogs remaining after our regular business hours will be boarded overnight and subject to boarding fees. When entering and exiting the facility, all dogs must be on-leash and under control of the Client.

The Client understands and agrees that all payments for services are due at time of service. Late payments will be subject to a late fee.

The Client, as the dog(s) owner, agrees to be solely responsible for any and all acts or behavior of the dog(s) while in the care of Cubby’s Canine Castle.

If Client’s dog(s) becomes ill or is deemed to be in need of medical attention Cubby’s Canine Castle reserves the right to administer aid or use any available veterinarian to administer aid. The Client agrees that Cubby’s Canine Castle has permission to seek veterinary care for the Client’s dog(s) and Client agrees to pay any expenses so incurred in administration of medical aid. Client agrees that Cubby’s may seek care through the Client’s regular veterinarian or another veterinarian based upon the nature of the illness and/or availability of the doctor. Client understands that Cubby’s will use their best judgment in obtaining veterinary care for the dog(s).

The Client certifies that in admitting Client’s dog(s) to attend Cubby’s, said admittance was based upon Client’s representations that Client’s dog(s) is/are in good health and has/have not harmed and/or shown aggressive or threatening behavior towards any person or any other dog.

The Client understands and agrees that Cubby’s Canine Castle will not be liable for problems, damage or injury caused by Client’s dog(s) provided that reasonable care and precautions are followed by daycare staff. The Client understands that Cubby’s Canine Castle, Inc. is fully insured.

The Client releases Cubby’s Canine Castle, Inc. of any liability arising from Client’s dog(s) participation in daycare. The Client understands that as in a child’s playground environment, in a playgroup for dogs, injuries may occur. The Client agrees that the socialization and exercise benefits inherent in daycare outweigh such risks.

By checking below, I am agreeing to all terms set forth through Cubby's Canine Castle as laid out in this registration form. I also agree to release Cubby's Canine Castle and any sub-contractors from any liability to any dog and/or person within the programs and services offered, and agree to accept full financial and other responsibility incurred as the result of the actions of myself and/or my dog.

I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT

Medical/Vaccination History

Please provide veterinary records showing up to date:
Rabies, Distemper or DHLPP, Parvo (if no DHLPP)
Records may be attached to application or faxed directly from your Veterinarian’s office to 610.592.9230

You can upload your vaccinations here

No File Chosen

File uploads may not work on some mobile devices.

Adittional vaccine documents

No File Chosen

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Additional vaccine documents

No File Chosen

File uploads may not work on some mobile devices.

Please upload dog license

No File Chosen

File uploads may not work on some mobile devices.

Heartworm medication name *

Flea & tick Preventative name*

Current Veterinarian *

Veterinarian Phone

Grooming Preferences:

Length*

Shaved Trim

Length left on dog in inches*

Face*

Shaved Round Square

Tail*

Shaved Fanned Ball at the end

Shampoo*

Hypoallergenic (No dyes, no perfumes) Oatmeal (Gentle but scented) Regular Strength (scented)

Oatmeal also includes a scented conditioner

Teeth Brushing? (5$ extra)*

YES NO

Frequency of Grooming*

6 Weeks 8 Weeks Other

If other please specify*

Once application is and most recent vet records are received, we will contact you to confirm your grooming appointment.

Comments

Training Information

I'm interested in (Select one)*

Has your dog had basic obedience training*

Yes No

Have you ever participated in any other type of training?*

Yes No

If yes, what level or type of training?*

Are there any medical or behavior issue that can affect training?*

Yes No

If yes, please explain *

Have you used training aids with your dog?*

Yes No

If yes, please explain *

How did your dog respond?*

Are you currently using these training aids*

Yes No

What are your goals with your dog?*

General Policies

There are a few general policies regarding dogs and training, for everyone's health and safety!

All dogs attending/involved in group classes and private instruction must be current on all vaccinations and copies of most recent veterinarian records must be submitted with this application. This includes vaccinations (or titer levels) for Rabies, DHLPP and Bordetella. Puppies under 4 months must have at least their first set of vaccinations to participate.

The trainer has the right to remove any aggressive dogs from any program, if the dog poses a threat to other dogs or handlers. Cubby's feels that dogs exhibiting aggression should have the opportunity to be trained and positive socialization achieved, but we feel it should be worked through in a private session not posing a threat to people and/or other dogs.

Once your participation in training has been confirmed by Cubby's Canine Castle staff, refunds will not be issued. Payment for training is due with registration. If paying by check, please make check payable to Cubby's Canine Castle.

Training session packages are non-refundable and sessions must be completed within three months of date of purchase.

By checking below, I am agreeing to all terms set forth through Cubby's Canine Castle as laid out in this registration form for this training service, as well as, any future training services. I also agree to release Cubby's Canine Castle and any sub-contractors from any liability to any dog and/or person within the programs and services offered, and agree to accept full financial and other responsibility incurred as the result of the actions of myself and/or my dog. I acknowledge that I have voluntarily applied to participate in Dog Training and Obedience Instruction activities at Cubby's Canine Castle. I am aware that these activities may be hazardous and that I or my dog could be injured. I am voluntarily participating in these activities with knowledge of the danger involved, and agree to assume any and all risks whether those risks are known or unknown.

This release is effective for this training session as well as any and all future Cubby's Canine Castle training activities in which I participate.

I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT

Signature*

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Use your mouse or finger to draw your signature above

Date/Time*