Register

REGISTER

Please submit your contact and pet information below. Your pet must have Rabies, Bordetella (Kennel Cough) and Distemper as required by state and city law and for safety reasons. This is the first step in your pet’s registration. We will contact you to discuss your pet’s needs once we have reviewed this initial registration form. If you do not hear from us within 48 hours, feel free to contact the office at 212.285.4900. Read our Testimonials for our client reviews.

PERSONAL INFORMATION

* = required field

First Name: *

Last Name: *

Mobile Phone: *

Address:

Apartment:

E-Mail: *

City:

State:

Zip Code:

Home Phone:

Business Phone:

PET INFORMATION

Pet Name: *

Age: *

Breed: *

Gender: *

Neutered/Spayed: *

Weight: *

FEEDING INSTRUCTIONS

Dry Food: *

Food Type:

Do Not Feed Unless:

AM Food:

PM Food:

No Health Problems:

VETERINARIAN CONTACT

Hospital Name: *

Veterinarian Name:

Office Phone:

Address:

Address 2:

Veterinarian E-Mail:

City: *

State: *

Zip Code:

Specialist Name:

Specialist Phone:

Specialist E-Mail:

MEDICATION & VACCINATION

Medications: *

Medications Timing: *

Other:

Rabies: *

DHPP: *

Bordatella: *

Has Your Pet Ever Bitten An Animal or Human?: *

Explanation:

Can Your Pet Have Treats?: *

Would You Like Your Pet Groomed?: *

If Your Pet Becomes Ill, Would You Like Us To ❓ *

The Following People May Drop Off/Pick Up My Pet::

CREDIT CARD INFORMATION

* You must bring your credit card in on your first day.

RELEASE AUTHORIZATION

  • This is a Contract between Doggie Day Care, Inc., T/A The Wagging Tail (hereinafter referred to as "Facility") and the pet owner whose signature appears below (hereinafter referred to as "Owner").
  • Owner agrees to pay the rate for day care, boarding, bathing, and grooming in effect on each date the pet is checked into the Facility as listed in the Facility.
  • Owner further agrees to pay all charges for special services requested, and all veterinary costs for the pet during the time said pet is in the care of the Facility
  • Owner assumes any expense or liability for injuries that Owner's pet may inflict upon any human or other pet while in the Facility.
  • Owner further agrees that the pet shall not leave the Facility until all charges are paid to the Facility.
  • By signing this contract and leaving said pet with the Facility, Owner certifies to the accuracy of all information given about said pet on the back side of this contract.
  • The Facility shall exercise reasonable care for the pet delivered by the Owner to the Facility for boarding, day care, grooming or bathing. It is expressly agreed by Owner and Facility that Facility's liability shall in no event exceed the current chattel value of a pet of the same species of the pet left at the Facility. The Owner further agrees to be solely responsible for any and all acts of behavior of said pet while it is in the care of the Facility.
  • Owner specifically represents that he or she is the sole owner of the pet, free and clear of all liens and encumbrances.
  • Owner specifically represents to Facility that the pet has not been exposed to rabies, distemper or bordetella within a thirty day period prior to being left for boarding, daycare, grooming, or bathing.
  • All charges incurred by owner shall be payable upon pick-up of pet, or when billed by Facility at the address listed on the other side of this contract. The Facility shall have, and is hereby granted, a lien on the pet for any and all unpaid charges resulting from boarding, daycare, grooming, bathing or any other service provided by Facility.
  • If pet becomes ill or if the state of the pet's health otherwise requires professional attention, the Facility, in its sole discretion may engage the services of a veterinarian or administer medicine or give other requisite attention to the pet and the expenses thereof shall be paid by the Owner. Owner gives consent to the Facility to act in Owner's behalf in obtaining emergency or any veterinary care at Owner's expense if deemed necessary by the Facility or any of its employees. Owner indemnifies and holds the Facility harmless for said expenses. services of a veterinarian or administer medicine or give other requisite attention to the pet and the expenses thereof shall be paid by the Owner. Owner gives consent to the Facility to act in Owner's behalf in obtaining emergency or any veterinary care at Owner's expense if deemed necessary by the Facility or any of its employees. Owner indemnifies and holds the Facility harmless for said expenses.
  • This contract contains the entire agreement between the parties. All terms and conditions of this contract shall be binding on the heirs, administrators, personal representatives and assigns of the Owner and the Facility.
  • Any controversy or claim arising out of or relating to this contract, or breach thereof, or as the result of any claim or controversy involving the alleged negligence by any party to this contract, shall be settled by arbitration in accordance with the rules of the American Arbitration Association, and judgment upon the award rendered by an arbitrator may be entered in any Court having jurisdiction thereof. The arbitrator shall, as a part of his/her award, determine an award to the prevailing party of the costs of such arbitration and reasonable attorney's fees of the prevailing party.

I agree to Terms & Conditions (By checking here I agree to pay all charges incurred): *
Check here if you accept these terms.

SUBMISSION CONFIRMATION

Submission Code: *
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Confirm Code: *