DOG GUEST PROFILE

** Fill this form out FIRST. Then proceed to fill out the Make A Reservation form.**

Please bring a copy of the vaccination records when you bring your dog in for a complimentary daycare behavior assessment. Appointments for assessments are required so that we may take the time to show you and your pet around our facility as well as go over guidelines.

Owner Information

Pet Owner's Name(s): *
Address:
City:
State:
Zip:
Email: *
additional email address :
Home (main) Phone Number:
Cell Phone Number:
Additional phone number(s):
At what number should we reach you in case of an emergency?:
In case of emergency (other than yourself) contacts information, list name and phone number:
Your pet will only be released to an authorized person. please list them here:
How did you hear of The Dogwood?:
Our Referral Program

If someone has referred you to us, we would like to thank them by giving them $10 worth of Dogwood Dollars. This can go towards any service here at The Dogwood. We sincerely appreciate our clients and like to reward them for referring our services.
Who referred you to The Dogwood?:

Vet Information

What Veterinarian Hospital / Clinic do you use?:
Address:
City:
State:
Zip:
Vet's Phone Number:
Who is your Veterinarian at that facility?::

Dog Information

General Questions

Authorization & Waiver

I am the legal owner of:
Disclaimer

1. My dog(s) is/are healthy and meet the required vaccine and parasite control protocols. I also attest that my dog(s) has/have not been exposed to any communicable diseases in the past 14 days. I further represent that during any subsequent visits to The Dogwood that my dog(s) will be free of illness and communicable disease during the preceding 14 days. I am aware that it is my responsibility to inform The Dogwood of any communicable disease exposure pertaining to my dog(s).

2. I agree that if any fleas or ticks are discovered on my dog(s) at any time during daycare, The Dogwood will administer treatment at my expense.

3. I understand my dog(s) must be spayed/neutered prior to attending daycare (for dogs 6 months of age or older).

4. I understand that daycare is a place where dogs co-mingle in groups. I accept the risk involved and agree that I am solely responsible for any damages resulting from injuries caused by my dog(s) while at The Dogwood. If any problem, illness or injury occurs with my dog(s), I understand The Dogwood will attempt to contact me immediately to discuss the situation and appropriate solution or treatment. However, in case of an emergency, to ensure the wellbeing of my dog(s), I authorize The Dogwood to obtain whatever treatment is necessary for my dog(s)' safety and health. I also agree to assume full financial responsibility for any and all medical expenses incurred. I waive any and all claims against The Dogwood, its employees and representatives, provided reasonable care and precautions were followed.

5. I certify that I have read, understand and will abide by the rules and regulations as set forth in this authorization, which will remain in effect until revoked by me.
Owner's Name:
I AGREE with this waiver:

Yes
I do NOT agree with this waiver**:

Yes
** Opt-Out Option

If you choose to opt out, you MUST contact The Dogwood directly at 605-232-3647 to make your appointment. This online form will be considered void.
Submissions

Submission of this online form does not guarantee a reservation.
We will contact you by the end of the same business to day to confirm the reservation.

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