Daycare & Boarding, must be altered & fully vaccinated

Doggy Drop Off

Prices are for 3 hours. Addidtional hours are charged based on number of dogs for drop off.

Day Care

Daycare packages reduce the cost per day.

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:

Gender

2) Does the animal(s) listed above have all vaccines up to date and current :

Please Select

3) Has the animal(S) listed ever taken a de-worming pill prescribed by your veterinarian in the last physical year :

Gender

4) How is the animal(S) listed above with regards to interacting with other animals (large/small) :

5) How is the animal(S) listed above with regards to interacting with people or children :

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 ?

7) How Would you Describe Your Animals Energy Level :

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

Phone Number

Emergency Contact Name

Emergency Contact Phone Number

Witness :