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Bay 6, 7450, 49th Ave Cres, Red Deer, Alberta, T4P 1X8
(403) 986-7529
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Boarding Rates
Extended boarding packages reduce cost per day
One Dog
$37.00
Two Dogs
$60.00
Contact Us
Lacey & Foxy’s Playground Inc. Doggy Daycare/Boarding Waiver Form
First Name
LastName
Registered Owner of Dog(S) Name
Breed of Dog(s)
1) Is the animal(s) listed above spayed or neutered:
Yes
No
Gender
Male
Female
2) Does the animal(s) listed above have all vaccines up to date and current :
Yes
No
Please Select
Male
Female
3) Has the animal(S) listed ever taken a de-worming pill prescribed by your veterinarian in the last physical year :
Yes
No
Gender
Male
Female
4) How is the animal(S) listed above with regards to interacting with other animals (large/small) :
Very poor
Poor
Good
Excellent
Unsure has they have not had much interaction
5) How is the animal(S) listed above with regards to interacting with people or children :
Very poor
Poor
Good
Excellent
Unsure has they have not had much interaction
6) For The Health and Safety of All Animals In Our Facility, to the best of your knowledge does your animal have flea’s/ticks or other parasites we should know About ?
Yes
No
7) How Would you Describe Your Animals Energy Level :
Lazy
Moderately Active
Active
Hyper Active
Comments
I have read and understand this waiver. I understand that there are potential hazards within this service being provided to my animal(S). I hereby accept this service and in doing so waive all rights to take any form of legal action against Lacey & Foxy’s Playground Inc, its officers, directors, employees or assigns that are providing this service to my animal(s).
Date
Signature
Address
Email
Phone Number
Emergency Contact Name
Emergency Contact Phone Number
Witness :
Submit
