1
Canine Design Dog Resort
Pet Profile
Dog Owner’s Name: ___________________________________________________________________
Address: _____________________________________________________________________________
Phone (Cell): ______________________________ Phone: (Home): ____________________________
Phone (Work): ____________________________ Phone: (Vacation): _________________________
Veterinarian’s Name and Phone: ________________________________________________________
Pet’s Name: __________________________________ Age: ______________
Spayed or Neutered: Yes / No
Male/Female
Breed: _____________________________ Color: _____________
Feeding Instructions (amount, times of day, etc.) ___________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Brand and/or type of food do you feed? __________________________________________________
Favorite Toys / Games: ________________________________________________________________
Treats/Food Toy (Ex: Kong): ___________________________________________________________
Food Allergies / Restricted Food: ________________________________________________________
Medical Conditions (Past or Present): _____________________________________________________
Medication(s) (Name, Dosage, Frequency): _________________________________________________
_____________________________________________________________________________________
Has your pet ever been aggressive or bitten someone? Yes / No
Has your pet ever growled or snapped at anyone who has touched his or her food or toys? Yes / No
Words my pet knows: (Ex: Sit, Down, Stay, Potty, ect. ): _____________________________________
_____________________________________________________________________________________
Has your pet ever been kenneled before? Yes / No
Any other special needs? ___________________________________________________
This pet loves to: ______________________________________________________________________
This pet hates to: ______________________________________________________________________
Special Handling / Other Notes (Ex: special quirks, deaf, blind, object guarding, dog aggression, storm
anxiety, separation anxiety, fears/phobias, etc.)
_____________________________________________________________________________________
_____________________________________________________
2
Canine Design Dog Resort
Rules and Policies
Thank you for choosing Canine Design Dog Resort to care for your pet while you are away. For your pet’s
comfort and security we recommend you bring your pet’s favorite food, bed, and toys. Below is the policy
we’ve designed with your dog’s health and safety in mind.
All dogs must be up to date on DHPP (Distemper, Hepatitis, Parainfluenza and Parvovirus), Rabies,
Bordetella (Kennel Cough) vaccinations and a fecal examination that is clear of parasites. You must bring
proof of this from your Veterinarian’s office and all records must be within a years date of boarding. No
pet can be boarded without proof of current vaccinations. No exceptions.
Owners must show a satisfactory receipt of purchase as proof that the pet is on a preventative flea program.
A dose of appropriate flea prevention will be applied if adequate proof of purchase is not provided or we see
evidence of fleas. The pet owner is responsible for an additional fee, not to exceed $20, for the application of
any flea prevention product or flea bath provided by Canine Design Dog Resort.
Drop off and pick-up times are flexible Monday through Saturday only. Sunday hours are 1:00 pm to 5:00
pm only. Sunday is our family day so arrangements for drop off and pick-up times must be within
scheduled hours for Sunday.
We want to make your pet feel as comfortable as possible so please feel free to bring anything your pet is
used to. We will return these items with your dog at check-out. Please label all items. Canine Design Dog
Resort is not responsible for lost or damaged belongings.
Your pet’s stay with us will include two feedings a day, individual and/or group play and medications if
needed. Your pet will be provided with 4 to 5 outside walks on our 9 acre facility. There is a risk factor
involved with this service. Leashes and collars can break. We do check leashes and collars to prevent this.
Please let us know if you want your pet walked outside and are in agreement with the risks involved.
YES / NO
Two dogs from the same household can share the same kennel run. The first dog will be charged a full rate
and the second dog will be charged at a half rate. We do not recommend more than two dogs per kennel
unless they are very small.
Owner understands that there is a full-day boarding fee charged on day of arrival (regardless of check-in
time and there is a charge for a FULL day ON THE DAY OF PICK-UP.
I have read and understand all of the above rules and policies. I agree to provide necessary medical records
for my dog(s).
Owner’s Signature:________________________________________________ Date: _______________
Canine Design Dog Resort
3
Individual and/or Group Play Policy
I, __________________________________ (Owner), hereby certify that my
dog(s),______________________________________ is/are in good health and have not been
ill with any communicable condition within the last 30 days, I further certify that my dog(s)
have not harmed or shown any aggressive or threatening behavior towards any person or any
other dog. Canine Design Dog Resort agrees to exercise due any reasonable care in
handling of dogs and in keeping the facility enclosed and sanitary. All dogs are cared for by
Canine Design Dog Resort without liability on Canine Design Dog Resort behalf for loss or
damage from disease, theft, fire, death, escape, injury, or harm to persons, other dogs, or
property by said dog(s), or for other unavoidable causes.
I HAVE READ AND UNDERSTAND THE FOLLOWING: Initial 1-9
1. _______ I understand that I am solely responsible for any harm caused by my dog(s) while
my dog(s) is/are in the care of Canine Design Dog Resort and release Canine Design Dog
Resort of any liability arising from my dog’s attendance and participation at Canine Design
Dog Resort or during socialized group play/individual play time.
2. _______ I recognize that there are inherent risks of illness or injury when animals are
allowed to be in close contact with one another. Such risks include, but are not limited to,
problems resulting from rough play.
3. _______ I further understand that by admitting my dog(s) to Canine Design Dog Resort ,
the staff at Canine Design Dog Resort have relied on my representation that my dog(s) is/are
in good health and have not harmed or shown aggressive or threatening behavior towards
any person or any other dog.
4. _______ I understand that my dog(s) will be playing in open areas with other dog(s) and
accept that when dogs play in groups, they will get dirty and nicks and scratches may occur,
as well as any other inherent risks that are involved and I hereby release Canine Design Dog
Resort of any liability; I further understand and agree that Canine Design Dog Resort staff
and volunteers will not be liable for any or all problems that may develop.
5. _______ I further understand and agree that any problems that may develop with my
dog(s) will be treated as deemed necessary by Canine Design Dog Resort staff and volunteers,
at their sole discretion, and I assume full financial responsibility for any and all expenses
involved if I or Canine Design Dog Resort decide to obtain medical treatment.
6. _______ I accept that if my dog causes any excessive damage to the facility that I could be
asked to pay for repairs.
7. _________ I further understand that if my dog(s) show any sign of aggression towards
other dog(s) that their acceptance into group play will be reevaluated.
4
8. _________ Human aggressive dogs, or dogs with fear issues, will not be allowed to
participate in socialized group/individual play time.
9. _________ As a responsible pet owner, I promise to keep my dog(s) up to date on all
vaccines, including Bordetella, Rabies, DHPP and all other state required vaccines. It is
required by Canine Design Dog Resort that you provide official updated records from a
Veterinarian before you are allowed to attend socialized group play/individual play time.
I certify that I have read and understand the policy of Canine Design Dog Resort as set forth
on the preceding page by initialing each section and that I have read and understood the
conditions and statement of this agreement.
I acknowledge and accept that all the above policies refer to socialized group play/individual
play time, as well as overnight stays, and this release serves as accepting these conditions for
this service.
_________________________________________
(Signature)
Canine Design Dog Resort
___________________
(Date)
5
Medical Release Form
If Canine Design Dog Resort staff deems your dog is in need of immediate Veterinary
care, or your dog presents with a potential illness and we are unable to contact you, or you
are unable to pick up your dog we will take your dog to a licensed Veterinarian. If your
personal Veterinarian is located in Danville, Illinois we will make every attempt to have
your dog taken to them. If your personal Veterinarian is unavailable, or we deem that
your dog needs immediate care, or your personal Veterinarian is out of our area, we will
transport to North Vermilion Hillcrest Small Animal Hospital, 2722 North Vermilion
Street, Danville, IL. 61832.
Phone (217) 443-0333
I, _____________________________________, as Owner of ____________________,
give permission for Canine Design Dog Resort to act as my agent in the event of my dog(s)
needing medical attention.
I further agree that I will be responsible for any and all cost of any veterinary care
deemed necessary by a licensed Veterinarian.
_______________________________________
(Signature)
____________________
(Date)
Canine Design Dog Resort
6
Aged Pet Release Form
The undersigned owner or guardian of the pet described on this release form has been
advised by Canine Design Dog Resort that when older pets are boarded they may be
placed under a great deal of stress. This stress can cause latent (dormant) physical
conditions (such as heart, liver and kidney disorders) to become active. This can result in
illness or death of the pet described below:
Last Name __________________________________________________
Pet’s Name _____________________________________________________
Age ______________________________
Breed ____________________________
Color ____________________________
Sex ______________________________
The undersigned has read and understands the above, and as the owner or
guardian for the pet described herein agrees to not hold Canine Design Dog
Resort responsible for the illness or death of their pet or for any expenses
incurred because of the illness or death of the pet described herein.
OWNER/GUARDIAN: ________________________________________
DATE: ______________________________________________________
Canine Design Dog Resort
7
Boarding Contract
This is a contract between Canine Design Dog Resort (hereinafter called “CDDR”) and
the pet Owner whose signature appears below (hereinafter called “Owner”) for boarding
Owner’s “pet”. (The term “pet” refers to all pets boarding with same ownership).
1. Owner agrees to pay the rate of boarding in effect on the date the pet is picked up
from CDDR. Owner further agrees to pay all costs and charges for special services (Ex:
Grooming, flea treatment).
2. Owner further agrees that the pet shall not leave CDDR until all accrued charges are
paid.
3. ABANDONMENT/NON PAYMENT OF CHARGES:
All charges become due on the date the pet is to be picked up. CDDR shall have, and is
hereby granted, a lien on the pet for any or all unpaid charges resulting from caring for
pet at CDDR. Owner agrees in the event charges are not paid within ten
(10) days
after they become due in accordance with this contract, CDDR may:
(1) exercise its lien rights by selling the pet to satisfy such lien and costs of sale at public or
private sale and if such sale does not secure a price adequate to pay such costs of boarding
or other delinquent charges plus the cost of sale, Owner must pay the difference to CDDR.
Notice shall be given pursuant to this paragraph if notice in writing of such intended sale
shall be mailed by registered mail to Owner of the within named pet at the address given
herein and no further notice shall be required. Owner shall remain liable for all boarding
fees. Should CDDR elect to sell the pet, any sale proceeds over and above the charges due
and costs of sale shall be paid to the owner.
4. REASONABLE CARE AND LIABILITY:
CDDR shall exercise reasonable care toward the respective pet delivered by the Owner
for boarding. Owner acknowledges that Owner is aware of and accepts the standard of
care used by CDDR for care and boarding of pet. CDDR shall not be held responsible for
any liability with respect to the pet listed in this agreement, of any kind, character, or
nature whatever arising out of or any damage which may occur from any other cause
whatsoever, including but not limited to: loss by fire, theft, running away, death injury to
persons, death injury to animals, death injury to property, or death or injury to any other
animal caused by the within named pet during the term of this contract, whether this
animal be on the premises of CDDR or not. The Owner of said pet agrees hereby to be
and is solely responsible for any and all acts of behavior at any time within the term and
time of this contract. In no case shall CDDR be in any way liable or responsible. Owner
expressly agrees that CDDR’s liability for negligence hereunder shall in no event exceed
of One Hundred Dollars (100.00) for any and all damages sustained or suffered by reason
of the boarding of this animal. The Owner agrees not to enact any claim against CDDR of
any nature whatsoever, either by way of contract, equity, negligence, or otherwise in
excess of said sum.
8
5. MEDICAL TREATMENTS:
The Owner represents that pet is healthy and has not been exposed to any known
communicable diseases within a thirty day period prior to boarding. The Owner shall
disclose elsewhere on this contract all known medical conditions and/or behavior
problems which may affect the pet’s care. It is the Owner’s responsibility to inform
CDDR of any changes in the pet’s condition for all subsequent stays. If the state of the
pet’s health requires medical attention, CDDR, in its sole discretion, may engage the
services of a Veterinarian, may provide First Aid, administer medications or special diets
or give other attention to the pet, and any and all expenses shall thereof by paid by the
Owner.
6. ANY CONTROVERSY OR CLAIM ARISING OUT OF OR RELATING TO THIS
CONTRACT OR THE BREACH THEREOF, OR AS THE RESULT OF ANY CLAIM
OR CONTROVERSY INVOLVING THE ALLEGED NEGLIGENCE BY ANY PARTY
OF THIS CONTRACT, SHALL BE SETTLED BY SMALL CLAIMS COURT
ARBITRATION IN ACCORDANCE WITH THE RULES OF THE AMERICAN
ARBITRATION ASSOCIATION AND JUDGEMENT UPON THE AWARD
RENDERED BY ANY ARBITRATOR MAY BE ENTERED IN ANY COURT HAVING
JURISDICTION THEREOF.
INITIALS:_________________________
OWNER
________________________
CDDR
7. This contract contains the entire agreement between the parties. All terms and
conditions shall be binding on the heirs, successors, administrators, personal
representatives, and assigns of Owner and Canine Design Dog Resort (CDDR).
8. The terms of this contract are binding and continuing and shall relate to all times the
pet is boarded unless a new contract is executed by the parties.
9. OWNER REPRESENTS (1) he or she is the sole owner of the pet, and (2) all conditions
medical and other stated below are a full and comprehensive list.
OWNER DISCLOSURE OF MEDICAL CONDITIONS AND/OR BEHAVIORAL
PROBLEMS:
_____________________________________________________________________________
_____________________________________________________________________________
______________________________________________________________
Dated:_______________, 20___
Canine Design Dog Resort: ____________________ Owner:_____________________