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THE DOG RESORTEnrollment Application 12140 Metro Pkwy, Ft Myers FL 33966Phone: 239-768-9800 FAX: 239-332-3031Name: ________________________________________________________________________________Address: ______________________________________________________________________________City/State/Zip: __________________________________________________________________________Phone numbers Home: _____________________ Work _____________________/___________________Cell: ________________/_________________ E-Mail Address: ___________________________________/_____________________________________I was referred to you by: _____________________________________________________________EMERGENCY CONTACT INFORMATION: (FAMILY OR FRIENDS):Name: ________________________________ Phone No:__________________________________Name.:_____________________________ Phone No __________________________________Please List Names & Phone #’S Of Others Who Have Permission To Pick Up Your Dog(S): _____________________________________________, ______________________________________________________________________________________, __________________________________________Medical Info & Veterinary ReleaseI understand that in the event of a medical emergency, which THE DOG RESORT C at its sole discretion deems to need the immediate attention of a licensed veterinarian. I authorize THE DOG RESORT LLC to seek medical attention at the closest available veterinary facility. I give permission to the attending veterinarian to diagnose and treat my dog(s). I further agree that I am financially responsible for any medical treatment my dog(s) receives as a result of a medical emergency. Signature of Owner ___________________________________________ Date ______________________Printed Name _______________________________________________Contact Numbers ___________________________, ______________________, ____________________THE DOG RESORT Service Agreement 12140 Metro Pkwy, Ft Myers FL 33966 Phone: 239-768-9800 FAX: 239-332-3031This is a contract between THE DOG RESORT INC and dog owner(s) for any service provided here. Your Name ____________________________________ Dog’s Name ______________________________The Dog Resort has relied upon my representation that my dog is in good health and has not been exposed to rabies or distemper within a thirty day period prior to any stay. My dog has not injured or shown aggression or threatening behavior to any person or dog. I understand that The Dog Resort Inc, their owners, staff, partners and volunteers will not be liable, financially or otherwise for injuries to my dog, myself, or any property of mine while my dog is participating in services provided by The Dog Resort Inc. I hereby release The Dog Resort Inc of any liability of any kind arising from my dog(s) participation in any and all service provided by The Dog Resort Inc.I understand and agree that any problems with my dog, behavioral, medical or otherwise will be treated as deemed best by the staff of The Dog Resort Inc in their sole discretion and in what they view as the best interest of the dog. I understand that I assume full financial responsibility and all liability for any and all expenses involved in regards to the behavior and health of my dog. I understand that there are risks and benefits associated with group socialization of dogs. I agree that the benefits outweigh the risks and that I accept the risk. I desire a socialized environment for my dog while attending services provided by The Dog Resort Inc and while in their care, I understand that while the socialization and play is closely and carefully monitored by The Dog Resort staff to prevent injury, it is still possible that during the course of normal play, my dog(s) may receive minor nicks and scratches from roughhousing with other dogs. Any injuries to my dog will be pointed out by staff upon pick-up. I understand by allowing my dog(s) to participate in services offered by The Dog Resort Inc, I hereby agree to allow The Dog Resort Inc to take photographs or use images of my dog(s) in print form or otherwise for publication and/or promotion. I understand that I am solely responsible, financially and otherwise, for any harm or damage caused by my dog(s) while they are attending any services provided by The Dog Resort Inc. I understand that if my dog is not picked up on time or by a date specified in a separate agreement, I hereby authorize The Dog Resort Inc to take whatever action is deemed necessary for the continuing care of my dog. I will pay The Dog Resort Inc the cost of any such continuing care. I understand that if I do not pick up my dog, The Dog Resort Inc will proceed according to the guidelines provided by Florida Statue 705.19 Abandonment of animals by owner; procedure for handling. I also acknowledge that I will be fully responsible for all attorney fees and associated costs if I abandon my dog. I agree, if my dog shows any signs of fleas or ticks during their stay, that The Dog Resort may bathe my dog and I will be charged accordingly. I agree to pay The Dog Resort Inc all charges for any service requests or necessary procedures for my dog before he/she may leave the premises. Signature of owner ____________________________________ Date ___________________Print name: __________________________________________DOG PROFILE THE DOG RESORT (__) For Staff Notations Your Last Name: _____________________ Dog’s Name: __________________________Breed:_______________________ (___)Color: ________________Markings: _____________________ Birthday:_________________Age:_________ Weight: ___________ Male:____ Neutered? ____ / Female:_____ Spayed? _____ Siblings?________________________________________________Brand Of Dry Food: ___________________________ Quantity Per Feeding:________________ Time: ____AM,___Noon, ___PMBrand Of Canned Food: ________________________Quantity Per Feeding:________________ Time: ____AM,___Noon, ___PMOther Food __________________________________ Quantity Per Feeding:________________ Time: ____AM,___Noon, ___PMTreats: ________________________Supplements: ______________________ Quantity ______When given: _________________Medications: _______________________________________________________________________________________________How old was your dog when you acquired him/her? ________ Where did you get your dog from? ___________________________Does your dog have prior off leash play experience? None ______ (___) Yes ______(___) If yes, where was this experience: Another dog daycare – which one? ___________________________________________ Public dog park _____ ____With a few other dogs,____ On leash play only. Has your dog ever been expelled from a daycare? ___ No___Yes (___)How would you best describe your dog’s usual play style? ___ Easy going, short games, ___Wrestle, chase, vocal during play, or___Rough, nonstop play, alpha, wants to be in charge. (___)How would you best describe your dog’s behavior when upset? ___Moves away, hides, submissive, ___Barks, shakes, whimpers, or ___Grumpy, growly, gets a “look”? (___)How would you best describe your dog’s prey drive? ___No indication of prey drive, ___Chase play style, focused, staring behavior, or ___ Chases squirrels, cats, bikes, cars, etc. (___)How well does your dog share food or toys? ____Shares food and toys with other pets, ___Shares unless high-value (e.g. bone, etc.) ___ Don’t know how my dog would react to sharing or ___ Separate to feed, growls/snaps if approached while eating. (___)Does your dog have a bite history or reaction when pushed? ___No bites or aggressive responses, ___Growly, snaps, single low-level bite, or ___High-level history with dogs or people; multiple instances. (___)Have you taken your dog to obedience classes and how often is training used at home? ___Multiple classes & constant use at home, ___One class & some use at home or ___No classes & rarely used at home. (___)Why do you want your dog to attend daycare? ___Play with other dogs, ___so not home alone, ___additional exercise to what dog gets at home. ___ Suggested by another person; ___separation anxiety; ___sole source of exercise ___looking for boarding ___ Would like my dog to socialize (___) What have you done in the past when you needed to board your dog?____________________________________________Are you interested in boarding you dog? ___ no; ___yes. If yes, When?______________ For how long? _______________Additional notes about your dog: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________It Is My Opinion That My Dog Is Of Adequate Health To Participate In Services Provided By The Dog Resort. Signature ____________________________________________________ Date __________________Print Name _________________________________________________DO NOT COMPLETE THIS FORM – This is what our staff will be using to evaluate your dog. You will be given a copy of the completed form along with additional information from The Dog Resort. Human InteractionsSpecificsScoreCommentsResponse to meeting peopletransition from owner to associateG: Initiates interaction & stays for more than 2 seconds. Y: Tolerates interaction & displays stress signalsR: Avoids greeting; displays warning signals or aggression: Response to touch and handling- taking leash/harness offG: Very acceptingY: Tolerates; displays stress signalsR: Displays warning signalsResponse to obedience cuesG: Attentive and responsiveY: Some positive responsesR: Ignores most cues and eye contactSubtotalPlaygroup BehaviorSpecificsScoreCommentsPlay behavior / Play StyleG: Appropriate in most instances; easily redirectedY: Frequent inappropriate behaviors or shows little interest in playing R: Consistently inappropriate play requiring redirectionNumber of stress signals displayed and length of timeG: Very few for a short period of timeY: Moderate number for a short amount of timeR: High level for extensive time periodOverall dog body language displayedG: Relaxed or playful postures most of the timeY: Alert, anxious, confident, or subordinate postures displayed frequently R: Aroused, fearful, predatory postures displayed frequentlyEnergy level during playgroupG: Low to moderate with play and rest cycles; self-controlY: Moderate; high at arrival or key events; few rest cyclesR: High most of period; instances of high arousal; rarely restsDoes dog share food, water & toys; reaction when approachedG: shares toys & food with other petsY: Shares unless high-value iten (e.g. bone, treat) R: separate to feed, growls/snaps if approached while eatingInstances observing inappropriate off-leash group behaviors: Bullying, aggressive, fear, lack of interest, mountingG: Rare InstancesY:Some instances; responds well to redirections; other dogs tolerate behaviors with appropriate corrections/warningsR: Frequent multiple redirections required to manage nappropriate behaviors; other dogs avoid the dogSubtotalDog GreetingSpecificsScoreCommentsReaction to entering playroom with no dogs in the roomG: Sniffs aroundY: Sticks close to associate, shows signs of stress, doesn’t check out surroundingsR: Anxious/stressed, cowers in corner, jumps at exits, pacingReaction to meeting balanced, confident dogs &/or first dogs introducedG: Polite behaviorsY: Some rude behaviors toleratedR: Rude behaviors corrected & accepted or avoids greetingReaction to meeting other individual dogsG: Polite behaviorsY: Some rude behaviors toleratedR: Rude behaviors corrected & accepted or avoids greetingReaction to being in small group of dogsG: Enjoys interactions; playsT: Tolerates interactions; some stress signals displayedR: Avoids interactions; multiple stress signals; warning signalsReaction to being in large group of dogs; prospective playgroupG: Enjoys interactions; playsY: Tolerates interactions; some stress signals displayedR: Avoids interactions; multiple stress signals; warning signalsSubtotalSubtotal from Dog ProfileG: 72-57, Y:56-42, R:41-28TOTAL SCORERecommendations: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ EVALUATOR(S) ________________________________________________________ DATE: __________________________ ................
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