10925 Eastex Freeway • Beaumont, TX 77708
409-892-PAWS (7297) • fax 409-892-2762 • www.camppaws.net
Grooming Package
Thank you for choosing Camp Paws for the care of your Camper(s)!
Please complete and fax the following forms:
1.
2.
3.
4.
5.
6.
Camper Profile (1 per Camper)
Grooming Agreement (1 per Camper)
Emergency Information (1 per Camper)
Pickup Authorization Form
Credit Card Authorization Form
Copy of Vaccination Records
We look forward to c are for your Camper(s) soon!
Camp Paws Team
Rev. Date 2/24/14
10925 Eastex Freeway • Beaumont, TX 77708
409-892-PAWS (7297) • fax 409-892-2762 • www.camppaws.net
Camper Profile
Parent’s name:
Phone numbers: (
)
(h) (
Email:
)
(c) (
)
(w)
What company do you work for?
Mailing address:
How did you hear about Camp Paws?
Camper’s name:
Sex:
Primary breed:
Color:
Approximate weight
Spayed
Neutered
Markings?:
Camper’s birthday:
/
Emergency contact name:
/
Microchip #
Phone:
(Must be someone other than co‐owner)
Veterinarian’s name, address & phone:
Dietary Profile
*A $2 per feeding will be charged for house food if own food is not provided.
Is your Camper on any special diet?
Yes
No
Will you bring your Camper’s food to Camp Paws?
Yes
No *We recommend you
bring your Camper’s regular food to avoid any possible digestive issues.
How many times a day would you like your Camper fed?
1x per day ( AM or
PM) /
2x per day /
3x per day
Quantity to be fed?
Cup(s)
Please list any food allergies?
Rev. Date 2/24/14
How does your Camper eat?
Fast
Slow
Medical Profile
Please list all medical conditions:
Has your Camper had any major surgery?
Does your Camper suffer from hip dysplasia?
Yes
Yes
No please list:
No
If yes, what restrictions need to be placed on your Camper’s activities/movements?
Is your Camper currently taking any medications?
Yes
No
* A $2 medication fee will be assessed per administration. (NO INJECTABLES)
If yes, please describe amounts, times per day, and special instructions:
* Medication must be in original packaging/container with labeled instructions from a licensed Vet. MEDICATION WILL BE ADMINISTERED ACCORDING TO DVM
INSTRUCTIONS ONLY.
Does your Camper have any sensitive areas?
Does your Camper use a flea preventative?
Yes
No
If yes, what brand?
*If there are any signs of either fleas or tick upon check-in, an immediate flea bath will be given
and owner understands an additional fee will be charged at check-out.
Owner’s initials
Is your Camper on heartworm medication?
Yes
No
Vaccination Profile
It is the responsibility of the client to provide proof of vaccination for each Camper. Campers whose
shots are not up to date will not be allowed to attend. The following vaccinations must have been
administered 5 days or more prior to attendance.
Rev. Date 2/24/14
Immunization Requirements - Dates given:
Distemper:
Bordetella (6 month vaccination):
Rabies:
_Parvovirus:
Owner understands that even if owner’s Camper is vaccinated against canine cough (bordetella), there is a
chance that the Camper can still contract canine cough due to various airborne infectious agents not covered
by vaccinations.
Owner’s initials
Behavioral Profile
Is your Camper house trained?
Yes
No
Has your Camper had any obedience training?
home/ _ class/
professional trainer
No
How would you rate the success of that training?
Yes (select answer) at
1
2
3
4
5
Describe your Camper’s personality (select all that applies):
Calm -
High Energy –
Playful –
Shy/Submissive –
Dominant –
Aggressive -
Affectionate Well behaved/ listens to Commands –
Barks Excessively –
Jumps on People
Separation Anxiety –
Destructive with Beds & ToysLoves to digPossessive with toys
Describe your Camper’s activity level:
Low /
Has your Camper ever bitten anyone?
Yes (stitches were required)
Medium /
High
No Yes (bite did not puncture the skin)
Yes (broke skin)
Has your Camper ever bitten another Camper? No
Yes (veterinary care wasn’t necessary) /
(Veterinary care was needed)
Does your Camper play with other Campers?
Males & Females
Only males:
Yes
Yes
No
Yes
No
Only females:
Yes
Yes
No
No
Are there any situations where your Camper may become unfriendly? Please describe:
Describe your Camper’s unfriendly behavior. (Select all that apply): Will bite/
Snaps/ _ Shows Teeth/
Freezes/ _ Trembles/
Moves Away
Rev. Date 2/24/14
May bite/
Growls/
Owner understands that if their Camper(s) exhibits aggression, excessive mounting, causes fights, injures other
guests or Camp Paws staff; Camp Paws reserves the right to terminate the daycare or boarding services, and will
contact the owner or its representative to remove the Camper from the facility.
Owner’s initials
How frequently is your Camper walked outside?
How long are your walks?
Is your Camper an escape artist or likes to run away?
Yes/
Has your Camper ever boarded before?
No
Yes/
No
If yes, where?
Has your Camper been in daycare before? If yes, where?
Other information about your Camper that you feel might be helpful?
Describe any behavior issues that you’d like to work on with your Camper:
Rev. Date 2/24/14
if yes, please explain:
10925 Eastex Freeway • Beaumont, TX 77708
409-892-PAWS (7297) • fax 409-892-2762 • www.camppaws.net
Grooming Agreement
Name:
Address:
Dog’s Name:
Age:
Weight:
Breed:
Sex:
Spayed/Neutered:
Intact:
Color/Markings:
Phone Number:
Email:
Veterinary Name & Number:
Is there anything we should be aware of before grooming your pet (anxious, nervous, doesn’t like ears
cleaned, nails cut…etc.)?
I,
the undersigned client, do hereby entrust my dog
Camp Paws Spa for the purpose of grooming my dog.
to
I agree to the following:
1. Your dog’s safety is first at Camp Paws Spa. We require a current copy of your dog’s vaccination
records. You may fax them to 409-892-2762.
2. If it is necessary for the safety of the dog and the groomer/stylist, muzzles, elastic collars, slings, straps
etc. will be humanely used.
3. I am aware that if my dog does not respond to the groomer/stylist and remain still during the grooming
procedure accidents can happen such as nicks from clippers or scissors or toenail trimmers. In either
case, you will always be advised of the situation upon pick-up.
4. For the dog to properly respond to the groom it is essential that the dog be alone with the
groomer/stylist and clients will not assist in the grooming unless requested to do so.
5. Customer assumes all liabilities, financial and otherwise, for the behavior and health of their dog while
in Camp Paws’ custody.
6. Customer will advise us of any allergies, sensitivities, or pre -existing medical conditions so we can
Rev. Date 2/24/14
avoid aggravating these situations. Please let us know of any prior grooming history you or your dog
may not have found satisfactory. We want to avoid the repetition of poor or unpleasant experiences or
situations.
7. Camp Paws Spa understands that some dogs are extremely sensitive to certain grooming procedures
such as nail trimming and/or ear cleaning. It is not our intent to cause your dog discomfort, so although
these are routine procedures normally performed for the well - being of the dog , we will not continue
with any grooming procedure that will cause pain, discomfort to the dog or harm to the groomer/stylist.
Sometimes, for a more sensitive dog, these procedures are best left to the care of a veterinarian.
8. Camp Paws Spa/the groomer will be held harmless from damages, loss or claims arising from any
known or unknown pre-existing condition of the dog.
9. Client authorizes Camp Paws to act as his/ her agent in the event emergency veterinarian services,
boarding, care-taking, and or transportation is necessary and agrees to pay all costs. Any/all damages
or claims shall include but not be limited to advanced age, extreme nervousness, neurosis, illness,
previous injury, skin or coat conditions or other medical conditions. Client authorizes Camp Paws to
use the credit card on file to pay for all costs.
10. If fleas are found on your dog, Camp Paws will administer a flea bath to eradicate the fleas in order to
maintain salon sanitation. This is at the groomer/stylist’s discretion and at the client’s expense. The
shampoo is gentle, non-alkaline and hypoallergenic.
11. Allowing a dog’s coat to get matted is not only very uncomfortable but dangerous for your dog’s
health. The groomer/stylist will de-mat the dog (if possible) at $30 per hour (minimum $15) in addition
to the regular grooming fee or the dog will receive a “shave down” to remove the mats. Under this
circumstance, a shave down is the only way to allow the skin to receive necessary oxygen and for new,
healthy hair to grow. Charges for the shave down or shaving ears and tail if they are matted are
determined on a per dog basis. If the client requests the mats be combed out, the groomer/stylist will
not do so if it causes the dog undue stress or pain. Excessive de-matting is a painful, time-consuming
and costly procedure that causes extreme discomfort and can aggravate (or cause) skin problems. I am
aware that neglect of my dog's coat can because for problems after grooming such as clipper/brush
irritation.
12. Shave downs or custom cuts that are outside normal specific breed haircuts will be discussed and the
groomer will perform the cuts to the best of his/her understanding of client’s directions and his/ her
ability but no other guarantee is made.
13. Shaving of your dog may dramatically change your dog’s appearance and the hair will be very close to
the skin. This may expose pre-existing skin conditions.
14. Every effort will be made to keep our scheduled grooms running smoothly. A typical dog groom can be
Rev. Date 2/24/14
completed in 2 to 3 hours from the time of your arrival. If your dog has behavior issues or skin and
coat problems you may be looking at a longer period of time.
15. Our groomers/stylists are trained professionals. We reserve the right to alter or cease any groom in the
event that our staff determines it is in your dog’s best interest or your dog displays aggressive
behavior. Customer understands that Camp Paws Spa has the right to refuse service to Customer's dog
(s) at anytime for any reason.
16. Some dogs will become very uncomfortable and/or scared during the grooming process and might
attempt to bite our Stylist/Groomer. In the event this happens, we will notify you and a special
handling fee will be accessed to your bill. Please let us know beforehand if you already know your
dog has this behavior.
17. We will use extra care and patience for older dogs; however, we will not be held responsible for any
reaction due to the mental or physical stress of grooming the geriatric dog. If, in our judgment,
brushing or clipping is determined to cause too much stress to the dog, we will modify or terminate
the haircut. Please be sure to notify us of any health conditions that might make your dog
uncomfortable during the bathing, drying, or clipping phases. Any grooming which takes place on an
elderly or frail dog is conducted at your risk.
18. Grooming prices are breed specific. If your dog is a mixture of breeds, the Groomer/Stylist will
determine pricing based on the type of coat and size of the dog.
19. I understand that if my dog is not picked up before 6:30 pm on weekdays, 2:00 pm on Saturday, my
dog will be considered boarding. I understand I will need to pay for the cost of boarding, house food,
and/or any late departure fees in addition to the grooming cost.
20. Camp Paws, LLC has the right to refuse grooming for any animal that may be a threat to itself or any
person.
21. I authorize Camp Paws to charge the credit card on file to satisfy any outstanding charges prior to the
release of my dog to me or any person approved in the Pickup Authorization Form.
RELEASE: I have read and understand the foregoing cautions printed above. I realize that grooming my
pet(s) may cause injury or allergic reaction to my pet(s), and should such an occurrence arise, I will be
responsible for any veterinary care required for my pet(s).
I consent to and authorize the grooming of my pet(s) and I release Camp Paws, LLC and its employees
and/or independent contractors from any liability arising out of performing of those services.
My pet(s) are also current on all vaccinations, including rabies.
Dog owner/guardian’s signature
Rev. Date 2/24/14
Dog owner’s printed name
10925 Eastex Freeway • Beaumont, TX 77708
409-892-PAWS (7297) • fax 409-892-2762 • www.camppaws.net
Emergency Information
Camper’s Name:
Breed:
Age:
Please list any pre-existing medical conditions:
Please list any medication being administered and doses per day:
If the dog named above becomes ill or is injured, I understand that Camp Paws& Grooming will
transport my dog to the closest veterinary care facility of their choice. Owner authorizes Camp
Paws to contact the below vet to obtain a full medical history:
Veterinary Office Name:
Address:
Phone Number:
I authorize Camp Paws to approve veterinary treatment up to $500.00. In the event of an injury or
illness, I understand Camp Paws will make every effort to notify me of the injury or illness, and medical
treatment.
I authorize Camp Paws to use the credit card on file to pay for all veterinary care cost. In the event
the credit card on file is declined, I will assume full responsibility upon my return for payment
and/or reimbursement for veterinary services rendered. I understand Camp Paws will not release
my dog until such reimbursement is made.
In the event my dog must receive overnight emergency care, I understand my dog’s reservation will
be terminated and it is my responsibility to make payment arrangements directly with the
veterinary clinic. I understand Camp Paws is not responsible for any additional medical veterinary costs.
I understand that Camp Paws cannot be held responsible for the results of the veterinary treatment
or the loss of my dog.
This agreement is valid starting on the date below whenever Camp Paws cares for my dog. I
understand it is my responsibility to update this emergency information whenever necessary.
Owner’s Name (Print):
Owner’s Signature:
Date:
Rev. Date 2/24/14
10925 Eastex Freeway • Beaumont, TX 77708
409-892-PAWS (7297) • fax 409-892-2762 • www.camppaws.net
Pick-Up Authorization Form
The following individuals have my permission to pick up my dog (s) from Camp Paws’ daycare,
boarding or grooming services. I understand that the credit card on file will be used to satisfy all
outstanding charges owe d to Camp Paws when the persons listed by me arrive to pick up my dog (s).
Name:
Relationship:
Ad dress:
Phone:
Name:
Relationship:
Ad dress:
Phone:
Name:
Relationship:
Ad dress:
Phone:
Under no circumstances will my dog(s) be released to anyone other than the individuals named
above without prior written authorization. I understand and Camp Paws may require a
Government Issue d identification to determine identity of those listed in this form. I understand
and Camp Paws may refuse to release my dog (s) if individuals refuse to provide identification.
Owner/Guardian’s Name (Print):
Owner/Guardian’s Signature:
Date:
Rev. Date 2/24/14
10925 Eastex Freeway
Beaumont, TX 77708
409-892-PAWS (7297)
Credit Card Recurring Payment Authorization Form
Schedule your payments to be automatically charged to your credit card. Just complete and sign this form to get
started!
Recurring Payments Will Make Your Life Easier:

It’s convenient (saving you time and postage)

Your payment is always on time (even if you’re out of town), eliminating late charges
Here’s How Recurring Payments Work:
You authorize regularly scheduled charges to your Visa, MasterCard, American Express or Discover card. You will be
charged each billing period for the total amount due for that period. A receipt will be emailed to you and the charge
will appear on your credit card statement. You agree that no prior-notification will be provided unless the date or
amount changes, in which case you will receive notice from us at least 10 days prior to the payment being collected.
Please complete the information below:
I ____________________________ authorize Camp Paws, LLC to charge my credit card account
(full name)
indicated below on the ________ of each ________ for payment of my doggie daycare.
(day or date)
(insert frequency)
I understand that I will only receive advance notice of the charge if it exceeds $ ________________
Billing Address ____________________________
Phone# ________________________
City, State, Zip ____________________________
Email
Account Type:
Visa
MasterCard
Amex
________________________
Discover
Cardholder Name _________________________________________________
Account Number
_____________________________________________
Expiration Date
____________
CVV (3 digit number on back of Visa/MC, 4 digits on front of AMEX) ______
SIGNATURE
DATE
I authorize the above named business to charge the credit card indicated in this authorization form according to the terms outlined above. If the above
noted payment dates fall on a weekend or holiday, I understand that the payments may be executed on the next business day. I understand that this
authorization will remain in effect until I cancel it in writing, and I agree to notify the business in writing of any changes in my account information or
termination of this authorization at least 15 days prior to the next billing date. This payment authorization is for the type of bill indicated above. I certify
that I am an authorized user of this credit card and that I will not dispute the scheduled payments with my credit card company provided the transactions
correspond to the terms indicated in this authorization form.
Rev. Date 2/24/14