Lucky Paws Dog Enrollment Form

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Hours For Wednesday, September 27th: 7-11am & 3-7pm

Lucky Paws Dog Enrollment Form

Dog Information:

Pet Name:		DOB:	/	Male Female	Size:
Breed:		Color:		Spayed/Neutered?

Vaccinations:

Food:

Is this dog current on the following vaccinations?

•Distemper •Bordatella •Rabies

Please provide documentation on all of these vaccinations.

Amount:	AM	PM
Food Notes:
Has this dog ever shown signs of food aggression?

Evaluation Questionnaire:

1. Has this dog socialized with dogs outside of your household?
2. How does this dog socialize with other dogs?
3. How does this dog socialize with new people?
4. Do you expect this dog to do well in the Lucky Paws daycare enviornment?
5. Does this dog have any injuries or health issues we should know about? (explain below)
Additional Comments:

Terms & Conditions:

I understand that I am solely responsible for any harm caused by my dog while dog is attending Lucky Paws, Inc. I further understand and agree that in admitting my dog to Lucky Paws, Lucky Paws representatives have relied on my representation that my dog is in good health and has not harmed or shown aggressive or threatening behavior towards any person or any other dog. I further understand and agree that any problems which develop with my dog will be treated as deemed best by staff and volunteers of Lucky Paws at their sole discretion, and that I assume full financial responsibility for any and all expenses involved.

I agree to allow this dog to co-mingle, to the terms and conditions above, and certify that all information provided is accurate to the best of my knowledge.

Date:

Full Name: (acts as signature)

Phone: --