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The Dogfather's Daycare
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To Book Please Call Ryan Lichty at 705-313-5255 or Email at
Ryan_lichty@hotmail.com
Please Fill Out the Application Below
Application Form
First name
*
Last name
*
Email
Phone
*
Address
Dog's Name
*
Breed/Age/Gender/Weight
*
Spayed/Neutered (Yes/No)
*
Up to Date Flea/Tick Medication (Yes/No)
*
Up to Date Vaccinations (Yes/No)
*
Bordetella (Kennel Cough) – Date Administered
*
Preferred Daycare Schedule
Is Your Dog Social with Other Dogs (Yes/No)
*
Is Your Dog Social with Humans (Yes/No)
*
Any History of Aggression (Yes/No)
*
Any Known Allergies? (Yes/No) If so please specify
*
Any Medical Conditions/Special Needs? (Yes/No) If so please specify
*
Emergency Contact Name
*
Phone Number
*
Veterinary Clinic Name
*
Veterinary Clinic Phone Number
*
Declaration I, __________________, certify that the information provided above is true and accurate to the best of my knowledge. I understand that any false information may result in the rejection of my application or termination of services.
*
Signature
*
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Today's Date
*
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