Follow on Facebook
|
Complete an Application
ABOUT
BLOG
SERVICES
PRICING
BOARDING RATES
DAYCARE RATES
GROOMING RATES
GALLERY
CONTACT
ABOUT
BLOG
SERVICES
PRICING
BOARDING RATES
DAYCARE RATES
GROOMING RATES
GALLERY
CONTACT
Application Form
Please enable JavaScript in your browser to complete this form.
Owner
*
First
Last
Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Phone
*
Email
*
Referred to Genesee Pet Resort By
Vet Information
Vet Clinic
*
Vet Phone
*
Emergency Contact
Emergency Contact
*
First
Last
Emergency Contact Phone
*
Boarding Information
Preferred Type of Boarding
Kennel
Suite
Requested Boarding Dates
*
From
To
Pet Information
Dog's Name
*
Breed
*
Color
*
Dog's Birthday
*
Sex
Male
Female
Type of Food
Canned Food
Dry Food
Special Diet
Number of Daily Feedings
Once Per Day
Twice Per Day
Three Times Per Day
Amount per Feeding
Small Animals
Multiple Choice
Cat
Guinea Pig
Bird
Rabbit
Fish
Other
If other, please specify:
Immunization
Rabies Due
DHLPP Due
Bordetella Due
Are there any allergies?
Yes
No
If yes, please describe.
Anything Contagious?
Yes
No
If yes, please describe.
Is your dog currently taking any medications?
Yes
No
If yes, please describe.
Has your dog had obedience training?
Yes
No
Is this the first time in a kennel?
Yes
No
Has your dog ever growled or snapped at anyone?
Yes
No
If yes, please describe circumstances.
Are there any behaviors or idiosyncrasies we should be aware of for the comfort and safety of your dog and his handlers?
Yes
No
If yes, please describe.
Second Dog
Second Dog's Name
Breed
Color
Birthday
Sex
Male
Female
Type of Food
Canned Food
Dry Food
Special Diet
Number of Daily Feedings
Once Per Day
Twice Per Day
Three Times Per Day
Amount per Feeding
Second Dog's Immunization
Rabies Due
DHLPP Due
Bordetella Due
Are there any allergies?
Yes
No
If yes, please describe.
Anything contagious?
Yes
No
Is your dog currently taking any medications?
Yes
No
If yes, please describe.
Has your dog had obedience training?
Yes
No
Is this the first time in a kennel?
Yes
No
Has your dog ever growled or snapped at anyone?
Yes
No
If yes, please describe circumstances.
Are there any behaviors or idiosyncrasies we should be aware of for the comfort and safety of your dog and his handlers?
Yes
No
If yes, please describe.
Agreement
*
I certify that my dog(s) is in good health, except as noted above, and has not been ill with any communicable diseases in the past 30 days; furthermore, I understand and agree that in admitting my dog(s) to Genesee Pet Resort LLC, GPR LLC has relied on my representation that my dog(s) has not harmed or shown aggression or threatening behavior toward any person or other dog except as noted above.
I certify my animal has been neutered.
I grant GPR LLC and its agents full power of decisions concerning the care and wellbeing of my dog(s).
*
Please enter your full name.
It is agreed that GPR LLC or its agents can and will make any needed decisions concerning medical treatment and choices of caregiver up to below dollar amount, which I accept full responsibility for payment.
*
Signature
*
Please enter your full name.
Date
*
Name
Submit
