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					                  Home from Home at Claire's

                  7 Wiltshire Avenue Swindon SN2 1NX
                 Tel: 01793 611255 Mob: 07760250646
                  homefromhomeatclaires@btinternet.com
                    www.homefromhomeatclaires.co.uk

                 Home Boarding Registration Form
                   Must be completed prior to boarding

                                 Dogs Details:

Name:

Microchip/Tattoo Number:

Sex & Breed:

Date of Birth:

Neutered/Spayed:                                    Yes/No

Brand of Food & Daily Quantity:

Treats allowed:

Normal Feeding Times:

Where does your dog sleep?

Health

Date of last vaccination:

Date of last Worming treatment:

Date of last Flea/Tick treatment:

Please provide full details of any health issues:




Insurance



Is your dog insured:                                Yes/No

If yes Insurance details:
                               Veterinary Details:

    Name:

    Address:

    Phone Number:

I authorise Home from Home at Claire's to call a vet on my behalf and
expense should it be necessary.
I authorise Home from Home at Claire's to transport my dog to the vets if
required. I will be responsible for any treatment or cost. If my vet can not
be reached in an emergency I authorise Home from Home at Claire's to
take my dog to the nearest vets or The Drove vets used by Home from
Home at Claire's.

      Owners Signature .......................................... Date.................




                                       Exercise:

      Duration of walks:

      Please make a brief note of your dogs daily routine:

      Do you let your dog off lead:                                       Yes/No

      If No please provide brief details why:

If Yes please sign below if you authorise your dog to be exercised off lead
during boarding.

      Owners Signature .......................................... Date.................

                         Training & Behaviour:

Do you attend any dog training clubs:                                   Yes/No
If Yes please provide club details:

Is your dog house-trained:                                  Yes/No
Has your dog shown any aggression towards people            Yes/No
Has your dog shown any aggression to other dogs             Yes/No
Does your dog pull on the lead                              Yes/No
Do you require Home from Home at Claire's to provide any training
Yes/No
If Yes please provide full details and discuss with Claire:
                            Owners Details:

Name:

Address:



Home Phone no:
Mobile:

Email:

Where did you hear about Home from Home at Claire's?




                       Emergency Contact Details:

Please provide contact details in case of emergency whilst your dog is
boarding

Name:                                   Relationship:

Address:



Home Phone no:
Mobile:

Do you authorise this person to make any decisions regarding your dog?

                                                             Yes/No

If No please provide full details of alternative




                            Booking Details:

Date and time of arrival:

Date and time of collection:

Number of days/nights:

Deposit enclosed:

£5 per day
                             Terms & Conditions:

Deposit required on booking late cancellation fee applies
Dogs only accepted at the discretion of Home from Home at Claire’s
The full outstanding balance is due on collection of your dog.
Cash or cheque with banker’s card accepted
Please make cheques payable to Claire Millward
Collection and delivery service available if required at an additional cost
subject to distance

No dogs registered under the Dangerous Dog’s act 1991
No dog hybrids registered under the Wild Animal act 1976
Entire males and bitches in season will not be boarded together
Dogs must have met the resident dogs prior to their stay and visited
Home from Home at Claire’s prior to boarding
When you sign you are confirming that you are boarding your dog/dogs at
Home from Home at Claire’s with the resident dogs
Jack(Cocker Spaniel) and Elle & Teigan (English Pointers)

From time to time it may be necessary to board dogs from different
households after a trial familiarisation period. Home from Home at Claire’s
is licensed and insured for four dogs to be home boarded.
Please sign below to authorise your dog/dogs to be boarded with dogs
from other households and you accept the terms and conditions of
booking.

        Owners Signature .........................................

        Date.................




     Please provide the following for your dogs stay:

Vaccination Card
Bed/Bedding
Grooming brush if applicable
Food Bowl
Food (if specific dietary requirement)
Lead & Collar (your dog will be issued with a new tag during boarding)
An item that has your scent on it




Date of Familiarisation:




Home from Home at Claire’s ............................Date...............

Home from Home at Claire’s w ill keep your information on file. Please notify us of
any changes. No details will be shared with any third parties. One Registration
Form per dog.
Additional Information: