Forms & Waivers Forms For personalized support and to better serve you, kindly take a moment to fill out the forms on our website. Registration Form Fill Out the Form Medical ReleaseForm Fill Out the Form Owners Agreement Form Fill Out the Form Pets must meet the following criteria to play at our facilities: Be people and dog friendly, not aggressive Have proof of rabies, distemper and bordatella (kennel cough) vaccinations Females cannot attend when in season Free of fleas and ticks (must be on prevention) White Mountain Dawg Barn Registration Form **Please fill out separate forms for each dog in household**Client InformationOwner First and Last Name: First Spouse or Partner Name (If applicable): First Address Complete Address: City: ZIP / Postal Code: PhoneCell PhoneEmail Typical work hours: Emergency Contact Info (friend or family): Alternate person who may pick up dog: Special Password: Pet InformationDog Name: First Dog Age & Birth Date: Breed: Weight: Check One: Male Female Check One: Spayed Neutered Unaltered Valid Tag or License #: Microchip or Tattoo Number: Pet Health ( Please attach a photocopy of immunization record )Dog has received complete immunizations for (check all): DHLPP Bordetella (Kennel Cough) Rabies Select AllName and phone number of vet: Clinic Name: Medical Conditions: Allergies: Has had flea/tick prevention: Yes No Has had heartworm prevention: Yes No Physical Limitations (sore back, hip dysplasia, etc.): Insured? Name of Company: Pet BackgroundPrevious obedience training: Interested in further training? Previous daycare experience: Previous overnight boarding experience: What is the most consecutive nights dog has been boarded: Is dog crate-trained? Yes No Is dog crated when left alone? Yes No Is dog used to a routine at home? What time is first out? Last Out? Does dog enjoy walks/hikes? Yes No Is dog leash trained? Yes No Any sensitive spots? How long have you owned this dog? How does your dog react to new dogs he or she meets? Dog is afraid of: Dog’s preferred reward: Favorite toys: Favorite games: Other notes: Pet Behavioral ChallengesBiting or growling at people (explain) Aggressiveness with other dogs (explain) Aggressive with/fearful of children (explain) Behavioral Challenges Shyness Jumping on people Jumping over fences Chewing or digging Chasing small animals Escaping out an open door Excessive pulling on leash Pulling out of leash Running away Other Select AllFeedingCurrent feeding schedule: Feeding instructions (time, amount): Preferred brand: Treats okay? Yes No Any food/treat dog may NOT have? Daycare Goal?What is your daycare goal (if applicable): Socialization Exercise Work on Separation Anxiety or Other: How did you hear about us? Google Search Social Media Referral Word of Mouth Online Review Other Δ MEDICAL RELEASE FORMThis is a required form for all White Mountain Dawg Barn participants receiving services. First and foremost, the safety and well-being of your dog(s) is of the highest importance. Ensuring that your pet remains safe and well cared for is our first responsibility and as such we take it very seriously. We do our best to have our pet parents screen for pre-existing health conditions; however, some factors may be beyond our control. If a medical emergency arises while a pet is at our facility or participating in a service that we provide it is imperative that we are immediately able to get them medical treatment at the closest available facility. We will call ahead to the veterinary offices in closest proximity geographically to us to ensure they can handle the emergency present. Your pet will be rushed to the closest available facility for treatment, and you will be notified. We notify the owner after we have secured a medical treatment center for the animal to avoid delays. Our goal is to get your pet medical attention as quickly as possible. For that reason, it is a requirement to have our pet parents sign this form. I acknowledge that WMDB is not trained in veterinary care and cannot diagnose/determine/recognize illnesses/Injuries that are occurring/have occurred/will occur with my dog(s), therefore I hold WMDB harmless and not liable for any medical problems my dog(s) have acquired. I understand that in the event of a medical emergency that White Mountain Dawg Barn, at its sole discretion, deems to need the immediate attention of a licensed veterinarian, I authorize White Mountain Dawg Barn to seek medical attention at the closest available veterinary facility. I further agree that I am financially responsible for any medical treatment my pet(s) receives because of a medical emergency while attending services provided by White Mountain Dawg Barn.Signature of Owner:Date: MM slash DD slash YYYY Printed Name: Δ Owner Agreement White Mountain Dawg Barn LLC This agreement shall apply to all boarding and/or daycare visits by your dog to White Mountain Dawg Barn. I represent that I am the legal owner or authorized by the owner of the dog(s) described on the application. I represent that my dog(s) is in good health, is currently on all required vaccination for Canine Distemper, Rabies, and Bordetella (Kennel Cough). Is free of fleas, ticks and lice (also on prevention) and has not been ill within the last 30 days. I understand that while my dog(s) is fully vaccinated, that vaccines are not guaranteed and there is a small risk that my dog(s) may contact a contagious disease or illness. I agree that should this occur, I am responsible for my own pet’s care, medical attention and costs. I release WMDB, its staff, owners and any representatives from any and all liability which I or my dog(s) may suffer including but not limited to injury, sickness, damage, or death resulting from participation in daycare and boarding. I understand that although all dogs are fully supervised, incidents of injuries may occur from playing with other dogs, which includes but not limited to bites, scrapes, scratches and sprains. I represent that my dog(s) is social and has not harmed or shown threatening behaviors towards any person or other dog. I understand the WMDB reserves the right to remove my dog from the play area and place my dog(s) in a separate holding area should my dog(s) display and unwanted behaviors. I allow WMDB’s staff to contact my veterinarian should any injuries or illness require medical attention. I agree that I am solely responsible for any medical expenses acquired for my dog(s). In the event that I or my authorized contact cannot pick up my dog(s) at the agreed pick-up time, I authorize WMDB to provide additional overnight and daycare services at my expense. I understand that if I pick up my dog(s) after 11am on the pick-up date from a boarding stay that I will incur a daycare charge. With my signature below, I certify that I have read and understand the agreement and waivers. I agree to abide by the regulations and accept all terms and conditions as set out.Signature of Owner:Date: MM slash DD slash YYYY Printed Name: Dog(s) Name(s): Δ