Day Camp Enrollment Form

I understand that prior to my dog (s) can be admitted into “The Club”, the
following requirements must be met:

All dogs must pass an evaluation.
All dogs must be fully vetted and our vaccine form must be completed.
All dogs must be spayed or neutered if over the age of six months.
All dogs must have a collar with ID tags.

How did you hear about us? (please check all that apply)

Web Search
Yellow Pages
Gazette
Flyer/Card
Dog Park
Pet Lovers Companion
Hotel
Veterinarian
Friend Referral
Pet Store
Other

Owner First Name
Last Name
Address1
Address2
City
State
Zip Code
Home Phone
Work Phone
Cell Phone
Email Address

Dog Information and Vaccine Record

Dog Name
Breed
Age
Dog's Sex	Male Female
Spay/Neutered	Spayed Neutered (required)
Any known Health Issues
Date DHLPP	(required)
Date Rabies	(required)
Date Bordatella	(required)
Date Heartworm Test	(required)

Veterinary Information

Primary Vet Clinic
Doctor
Veterinary Address
City
State
Zip Code