33501 8 Mile Road

Livonia, MI 48152
734-522-PAWS

Human’s Information
Name_____________________________________________________

Address_______________________________________ City___________________ Zip_______________

Home Phone__________________________ Cell Phone_________________________

Work Phone____________________________ Place of Employment______________________________

Email Address________________________________

Where did you hear about us? _______________________________________________

Emergency Contact Information

Name________________________________ Phone_____________________________

Vet’s Name ___________________________ Phone ____________________________

Dog Profile
Dog’s Name _____________________ Dog’s Sex _______ Spayed or Neutered? _______________________

Dog’s Breed______________________ Dog’s Age_______ Dogs Birthday (approximately is ok)? _________________

Is your dog house trained? ____________ Is your dog crate trained?_______________

What brand of food does your dog eat? __________________________

How many times a day?___________________ What are the portions?_____________________________

Are there any food allergies?______________________ Are treats allowed?________________________

Does your dog take daily medications? _______ If so, for what? _______________________ How often? ________

Does your dog have any past injuries or any current conditions? _____________________________________

Is your dog frightened by any noises? __________________________________________________________

What happens when you or somebody else tries to take food or toys from your dog? _____________________________

_________________________________________________________________________________________________

How often does your dog play with other dogs and what kind are they?________________________________________

Are there any kinds of dogs yours automatically dislikes?________________________________________________

Has your dog attended daycare before?____________ If so where?__________________________

What was his/her experience?__________________________________________________________

Has your dog boarded before?_______________ If so where?____________________________

What was his/her experience?____________________________________________________

Has your dog had obedience training? ________ What commands does your dog know? ___________________

_________________________________________________________________________________________

Does your dog have any sensitive areas on the body? _______________________________________________

How does your dog react to strangers? _____________________________________________

Rate you dog’s energy level “1” being very mellow and “10” being a total uncontrollable spaz ________________

Does your dog show any destructive behaviors when you aren’t at home? _________________________________

Is your dog aggressive on leash? _______ Off leash? _______ Do you walk your dog often? _________

Does your dog jump on you? _______ On others? _______

Does your dog growl? _________ Is it a play growl or a warning growl? __________________________

Has your dog ever bitten anybody? ___________ What were the circumstances? ____________________________

Has your dog ever jumped or climbed over a fence? _________ How high was it? _________
 4-Legged Friends Daycare
Owner’s Agreement

I understand and agree that in admitting my dog(s) to 4-Legged Friends Daycare, their staff have relied on my
representations 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.

I further understand and agree that 4-Legged Friends Daycare staff and volunteers will not be liable for any problems that
develop, regarding my dog(s). I hereby release 4-Legged Friends Daycare, LLC, its employees, agents, and volunteers from
any liability of any kind whatsoever arising from my dog(s) attendance, care and participation at 4-Legged Friends Daycare,
or in connection with any casualty occurring to my dog(s) or any person, including me.

I further understand and agree that any problems that develop with my dog(s) will be treated as deemed best by staff and
volunteers of 4-Legged Friends Daycare in their sole discretion, and I assume full financial responsibility for any and all
expenses involved.

I understand that I am solely responsible for any harm caused by my dog(s) while my dog(s) is/are attending 4-Legged
Friends Daycare. And I further agree that I am solely responsible for any and all acts or behavior of my dog(s) while in the
care of 4-Legged Friends Daycare.

I agree that my dog(s) will be picked up by myself or a pre-approved agent by closing or my dog will be boarded overnight
at the normal rate.

I agree that my dog(s) may be video taped, photographed, and recorded. 4-Legged Friends Daycare shall be the exclusive
owner to the results and all proceeds of such tapings, photography, and recordings with the rights, throughout the world, an
unlimited number of times in perpetuity, to copyright, to use and to license to others in any manner. I further agree that my
dog(s) may be used in any and all media and in the promotion, advertising, sale, publicizing, and exploitation of 4-Legged
Friends Daycare.

I certify that I have read and understand the policies set forth on the preceding pages and that I
have read and understand this agreement. I agree to abide by the rules and regulations and accept
all terms, conditions, and statements of this agreement.

Signature of Owner _______________________________________________________ Date ________________________

Name of dog(s)________________________________________________________________________________________

Health and Temperament Certification

I, __________________________________ hereby certify that my dog(s) _________________________________________

is/are in good health and have not been ill with any communicable condition in the last 30 days.

I further certify that my dog(s) have not harmed or shown aggressive or threatening behavior towards any person or any
other dog. And that my dog(s) is/are current on the following vaccinations: Distemper, Parvo, Bordetella, and Rabies. I
also agree to maintain vaccinations and to keep 4-Legged Friends Daycare appraised of any updates.

Signature of Owner _______________________________________________________ Date: ________________________