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3 - Dog Camp LA

VIEWS: 5 PAGES: 5

									                                               PHONE( 323) 993-7206 FAX( 323) 666-9540
                                                    http://www.dogcampla.com
                                                   email: hello@dogcampla.com
DATE: _________________________________
HOW DID YOU HEAR ABOUT US? ____________________________________________________________________________________________________________


PARENT INFORMATION:
NAME(S)_______________________________________________________________________________________________________________
ADDRESS: _ _____________________________________________________________________________________________________________________________________
PHONE:( ) _____________________________________________ WORK:( ) _____________________________________________________________________
CELL:( ) _____________________________________________ EMAIL: _______________________________________________________________________________
CELL:( ) _____________________________________________ WORK:( ) _________________________________________________________________________
EMER. CONTACT: ________________________________________________________________ PH.( ) ____________________________________________


PET INFORMATION:
NAME: ______________________________________________ BREED: _________________________________ AGE: __________ GENDER: M/F
NAME: ______________________________________________ BREED: _________________________________ AGE: __________ GENDER: M/F
NAME: ______________________________________________ BREED: _________________________________ AGE: __________ GENDER: M/F
NAME: ______________________________________________ BREED: _________________________________ AGE: __________ GENDER: M/F
NAME: ______________________________________________ BREED: _________________________________ AGE: __________ GENDER: M/F
NAME: ______________________________________________ BREED: _________________________________ AGE: __________ GENDER: M/F
NAME: ______________________________________________ BREED: _________________________________ AGE: __________ GENDER: M/F
NAME: ______________________________________________ BREED: _________________________________ AGE: __________ GENDER: M/F
NAME: ______________________________________________ BREED: _________________________________ AGE: __________ GENDER: M/F
NAME: ______________________________________________ BREED: _________________________________ AGE: __________ GENDER: M/F
NAME: ______________________________________________ BREED: _________________________________ AGE: __________ GENDER: M/F
VETERINARIAN INFORMATION:
VETERINARIAN: ______________________________________________________________________ PHONE: _______________________________________________
ADDRESS: ______________________________________________________________________________________________________________________________________
VACCINATION RECORDS:
DHLP-P: ________________________________ BORDETELLA: ___________________________________ RABIES: __________________________________________
DCLA EMPLOYEE INITIALS _________________________________________ SPAYED/NEUTERED: _________________________________________________
DO YOU HAVE AN ACCOUNT WITH YOUR VETERINARIAN? Y/N
IF NOT, YOU ARE REQUIRED TO LEAVE A SIGNED BLANK CHECK ADDRESSED TO YOUR VETERINARIAN, OR A
VALID CREDIT CARD FOR VET EMERGENCIES .

PERSONALITY/BEHAVIOR:
HAVE YOU EVER TAKEN YOUR DOG/PET TO A DOG PARK? IF SO, WHAT WAS YOUR DOG’S/PET’S EXPERIENCE LIKE?



HOW IS YOUR DOG/PET WITH: LOUD NOISES, CATS, BIRDS, SQUIRRELS, AND DOGS?



WHAT IS YOUR DOG/PET LIKE ON LEASH? DOES HE/SHE REQUIRE A HALTI OR SPECIAL COLLAR?

IS YOUR PET AN ESCAPE ARTIST?


DOES YOUR DOG/PET PLAY WITH OTHER DOGS/PETS ON A REGULAR BASIS? IF SO, WHEN THEY PLAY, DOES YOUR DOG/PET
SEEM DOMINANT, SUBMISSIVE, OR NEITHER?




DOES YOUR PET LIKE TO PLAY WITH TOYS? DOES HE/SHE SHRED THINGS? CAN HE/SHE SHARE TOYS? BONES? RAWHIDES?
SLEEP OVER:
HAVE YOU EVER LEFT YOUR PET OVER NIGHT? IF SO, WHERE? WHAT WAS YOUR PET’S EXPERIENCE LIKE? DOES YOUR PET
SUFFER FROM SEPERATION ANXIETY?




WHERE DOES YOUR PET SLEEP AT HOME? ( ie: BED, CRATE, FLOOR)
IS YOUR PET POTTY TRAINED? DO YOU USE FLUSHABLE CAT LITTER?
DOES YOUR PET HAVE A PROBLEM WITH HAIRBALLS?
WHAT KIND OF FOOD DO YOU FEED YOUR PET? HOW IS YOUR PET’S DIGESTION? ANY WEIGHT PROBLEMS?

WHAT ARE YOUR FEEDING INSTRUCTIONS?




ANY MEDICATIONS?

DO YOU FREQUENT A LOCAL GROOMER?
DO YOU HAVE A CARRIER FOR YOUR PET?
BURGLAR ALARM CODE:
NEWSPAPER DELIVERY? MAIL?
ANY OTHER DELIVERY OR SERVICE PEOPLE?
DO YOU NEED ANY PLANTS WATERED?

IS YOUR PET ON A FLEA PROGRAM? Y/N (FLEA CONTROL IS MANDATORY AT DCLA. DOGS MUST TAKE DROPS OR PILLS
NO LESS THAN 2 DAYS BEFORE VISITING DCLA)
PLEASE GIVE US ANY OTHER INFORMATION THAT YOU FEEL MAY BE HELPFUL IN MAKING YOUR DOG’S/PET’S STAY WITH
US AS ENJOYABLE AS POSSIBLE!
                                                          SERVICE AGREEMENT
      I UNDERSTAND AND AGREE THAT DOG CAMP L.A. AND IT’S STAFF HAS RELIED ON MY REPRESENTATION THAT
      MY PET(S) IS (ARE) IN GOOD HEALTH AND HAS NOT HARMED OR SHOWN AGGRESSIVE BEHAVIOR OR
      THREATENING BEHAVIOR TOWARDS ANY PERSON OR ANY OTHER PET.
      I FURTHER UNDERSTAND THAT I AM SOLELY RESPONSIBLE FOR AND AGREE TO INDEMNIFY DOG CAMP L.A., AND
      IT’S STAFF FROM ALL LIABILITY INCURRED AS A RESULT OF ANY HARM CAUSED BY MY PET(S) WHILE MY PET(S)
      IS (ARE) AT 1421 WESTERLY TERRACE OR UNDER THE SUPERVISION OF DCLA’S STAFF.
      I FURTHER UNDERSTAND AND AGREE THAT DOG CAMP L.A. AND IT’S STAFF WILL NOT BE LIABLE FOR ANY
      PROBLEMS THAT DEVELOP PROVIDED REASONABLE CARE AND PRECAUTIONS ARE FOLLOWED, AND HEREBY AGREE
      TO RELEASE THEM AND HOLD THEM HARMLESS FROM ANY LIABILITY OF ANY KIND WHATSOEVER ARISING FROM
      MY PET(S) BEHAVIOR UNDER DCLA’S CARE ON OR OFF THE PREMISES OF DCLA .
      I FURTHER UNDERSTAND AND AGREE THAT ANY PROBLEM THAT DEVELOPS WITH MY PET(S) BEHAVIOR WILL
      BE TREATED AS DEEMED BEST BY THE STAFF OF DCLA IN THEIR SOLE DISCRETION, AND THAT I ASSUME FULL
      FINANCIAL RESPONSIBILITY FOR ANY AND ALL EXPENSES INCURRED.
I CERTIFY THAT I HAVE READ AND UNDERSTAND THE RULES AND REGULATIONS SET FORTH IN THIS AGREEMENT.
I AGREE TO ABIDE BY THE RULES AND REGULATIONS AND ACCEPT ALL THE TERMS, CONDITIONS, AND STATEMENTS
OF THIS AGREEMENT.

SIGNATURE OF OWNER(S): _____________________________________________________________________________ DATED: ____________________________

                               _____________________________________________________________________________ DATED: ____________________________




CREDIT CARD INFORMATION:
IF YOU DO NOT HAVE AN ACCOUNT WITH A 24-HR VET OR WISH TO OPEN AN ACCOUNT WITH DOG CAMP L.A. , PLEASE
FILL OUT THE FOLLOWING:
VISA/MC# ______________________________________________________________________ EXP.DATE: __________________________ CODE: _____________
AMEX# __________________________________________________________________________ EXP.DATE: __________________________ CODE: _____________
NAME AS IT APPEARS ON CARD: ____________________________________________________________________________________________________________
I AUTHORIZE THE MANAGEMENT OF DOG CAMP L.A. TO CHARGE MY CREDIT CARD WITH PRIOR CONSENT.

_______________________________________________         ________________________
CARDHOLDER SIGNATURE                                   DATE
                                        PHONE( 323) 993-7206 FAX( 323) 666-9540
                                             http://www.dogcampla.com
                                           email: hellodcla@dogcampla.com
DOG WALKING: $25- per hour per dog. $22 per 45 min. per dog. $20- per half hour per dog. Discounts offered
for multiple dogs in same household. Rates vary for locations outside of DCLA’s 3 mile radius. Call for a quote
in your area.
DOG HIKES: $35 per dog 65-75 min. Discounts offered for multiple dogs in same household. Rates vary for
locations outside of DCLA’S 3 mile radius. Call for a quote in your area.
DOG PARK/PLAYCARE/SOCIALIZATION TRIPS: $35 per dog- 2 hour minimum for dog friendly outing.
Discounts offered for multiple dogs in same household. Rates vary for locations outside of DCLA’s mile radius.
Call for a quote in your area.
PET TRANSPORTATION: $25 per hour plus gas $(amount varies) $5 extra fee for crate handling and extra fees
for multiple pets. Rates vary for locations outside of DCLA’s 3 mile radius. Call for a quote in your area.
SUPER HAPPY FLUFFY DOG WASH AND WALK: $45 per dog includes round trip to local groomer and a walk
upon return.
IN-YOUR-HOME PET SITTING:
$70 base rate for 1 dog or first pet
$90 for 2 dogs
$20 extra per additional dog
$6 extra per cat and other small fluffy, feathered, or scaly creatures.

We also bring in the mail, water plants, put out the garbage and change up the lights. Extra fees may incur if
out of 3 mile radius of DCLA, if medication is dispersed, raw food diets are implemented, or if multiple pets are
involved. Rates vary depending upon quantity and cared needed. All pet sitting charges are a flat rate per
calendar day.
INTERVIEW FEE: $10
SAME DAY BOOKING FEE:          $5.   Please book a minimum of 12 hours in advance to avoid fees.
CANCELLATION FEE: 6 hours advance notice is necessary for all cancellations.
PICK UP AND DELIVERY: $8 each way per animal. Extra charge if out of 3 mile radius of DCLA.
KEY PICK UP: $8
MEDS: $3           RAW FOOD DIETS: $3
CRATING: $15 extra per calendar day (for dogs who are not potty trained)
HOLIDAYS: $10 extra fee per day for sitting and per walk. $100 non refundable deposit for major holidays.
Holidays are: Martin Luther King Jr. Day, Valentine’s Day, President’s Day, Easter, Mother’s Day, Memorial Day,
Father’s Day, Independence Day, Labor Day, Columbus Day, Thanksgiving, Christmas Eve, Christmas, New Year’s
Eve, and New Year’s Day. $100 non refundable deposit for major holidays.

								
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