GENESEE PET RESORT LLC

Application Form

Please fill in all possible form fields.

General Information

Owner:     Home Phone:    Cell:

Address:     City:     State:     Zip:

Contact e-mail:

Vet Clinic:     Telephone:     

Emergency Contact:     Number:

Referred to Genesee Pet Suites by:

Preferred Type of Boarding:      Kennel:      Suite:      

Requesting Boarding Dates:      From:       To:

Complete the following:

More than one animal Fill in animals separately.

Dog's name:     Breed:     Color:     Birthday:

Sex:     Normal Diet-Canned Food:     Dry Food:

Number of Daily Feedings:      Amount per Feeding:

Immunization Record

Rabies Due:     DHLPP Due:     Bordatella Due:

Are there any allergies/describe:    

Anything contagious:

Medication:     Describe:

Has your dog had obedience training?    Is this the first time in a kennel?

Has your dog ever growled or snapped at anyone?

If so describe circumstances: 

 

Are there any behavior problems or idiosyncrasies we should be aware of for the comfort and safety of your dog and his handlers?

 

2nd Dog

Dog's name:     Breed:     Color:     Birthday:

Sex:     Normal Diet-Canned Food:     Dry Food:

Number of Daily Feedings:      Amount per Feeding:

Immunization Record

Rabies Due:     DHLPP Due:     Bordatella Due:

Are there any allergies/describe:    

Anything contagious:

Medication:     Describe:

Has your dog had obedience training?    Is this the first time in a kennel?

Has your dog ever growled or snapped at anyone?

If so describe circumstances: 

 

Are there any behavior problems or idiosyncrasies we should be aware of for the comfort and safety of your dog and his handlers?

 

Agreement

I certify that my dog(s) is in good health, except as noted above, and has not been ill with any communicable diseases in the past 30 days; furthermore I understand and agree that in admitting my dog(s) to Genesee Pet Resort LLC, GPR LLC has relied on my representation that my dog(s) has not harmed or shown aggressive or threatening behavior towards any person or other dog accept as noted above.

I certify my animal has been neutered.

I grant GPR LLC and its agents full power of decisions concerning the care and will being of my dog(s). Should any medical emergency arise, it is agreed that GPR LLC or its agents can and will make any needed decisions concerning medical treatment and choices of caregiver up to $ which I accept full responsibility for payment.

 

Signature:     Date:

Genesee Pet Suites LLC will respond to your application request in no more than about 48 hours.