Home Boarding & Day Care Registration and Consent Form

About Your Dog

Name of Dog

Breed of Dog

Date of Birth

Colour

Distinguishing features/ markings:

Sex

Suitable ID worn on collar?

Is your dog neutered?

If no, female and over 12 months old we may not be the right place for your dog. I own and take in entire / intact male dogs. Please contact us.

Microchip details

Are the details on your dog’s microchip up to date?

Is your dog insured?

Insurance details

About You

Owner's Name

Address

Mobile Number

Email Address

Partner/Spouse Name & Mobile (if applicable)

Emergency Contact

PLEASE NOTE: YOUR EMERGENCY CONTACT MUST NOT BE ON HOLIDAY WITH YOU OR AT THE SAME TIME AS YOU

Will your Emergency Contact collect your dog in the event of an emergency?

Emergency Contact Name

Emergency Contact Number

Emergency Contact Email

Emergency Contact Address

Emergency Contact's Relation to Owner

Will your Emergency Contact make medical decisions in your absence?

Is your Emergency Contact named as an approved medical decision maker with your vet?

Health Section

Please note that the information in this section will be shared with a vet if your dog requires emergency treatment whilst in our care, and therefore must be clear and accurate.

Vet Practice Name

Vet Practice Address

Vet Practice Telephone

Vet Practice Out of Hours Service No

In the event of a real emergency ie the dog being hurt/ ill and needing immediate attention – Waggy Walks will take your dog to their own registered vet – Wern Vets in Llanrwst for assessment and then ring the owner / emergency contact.

You need to agree that your dog may be taken to another / nearer vet (as above) if the treatment needed is urgent?

Does your dog take regular medication?

Does your dog have any allergies? Anxieties?

Is your dog in good health?

Booster Vaccinations up to date?

Kennel Cough Vaccinations up to date?

Worming

Flea & Tic Treatment

Food And Snacks

Please note that the information in this section will be shared with a vet in the event that your dog requires emergency treatment whilst in our care, and therefore must be accurate.

What do you feed your dog?
Please tell us the brand(s) of food that you feed your dog - even though you are providing your own food. This information is needed in case of veterinary emergency.

Declaration

I hereby confirm that I am the owner of the pet named on this form and that I authorise Waggy Walks to act as my pet’s guardian whilst providing the Day Care or Home Boarding services.

I authorise Waggy Walks to take any action considered reasonable and appropriate to protect my pet and keep it in good physical and mental health, including admission for veterinary treatment or transferring to alternative boarding facilities. I further confirm that I will be responsible for unexpected costs which may be incurred whilst my pet is in the care of Waggy Walks (costs such as but not limited to veterinary care, boarding fees, equipment, and property damage).

If my dog is unwell, and I am not able to be contacted, I give Waggy Walks permission to authorise emergency veterinary treatment on my behalf and have also signed a Vet release & Service Agreement confirming this.

I confirm that I have read, understood, and signed the Waggy Walks Service Agreement in conjunction with this Registration and Consent form.

I attest that the information I have provided in this document is an accurate account of my pet’s needs and behaviour. I am aware that if my dog behaves in a manner which is dangerous to a person or another dog in Waggy Walks care, I will be contacted immediately and must make alternative boarding arrangements for my dog. I undertake to keep Waggy Walks informed of any changes in my pet’s health, behaviour, or medical needs before making each new booking.

I understand that if I do not use the services for twelve months or more, I will be required to re-register and my dog must undertake another trial and assessment prior to booking.

I agree that this consent shall remain in effect until it is superseded with a new version, or the requirement for Services is terminated by either party in writing, in accordance with the terms of the Service Agreement.