Last Name First Name Dog Name
Address City/State Zip Cell Phone
Email Emergency Contact Relation Phone #
Please place a check beside the following items as it relates to your pet
Neutered (required for Males to stay in our care)
- Spayed (required for Females to stay in our care)
- Aggressive (not allowed in our daycare, please be honest with yourself and with us about your dog’s personality)
- Dominant (Not Dominant Aggressive. That type of dominant behavior is not allowed in our daycare).
Please use the lines provided below to briefly describe methods used and any helpful information.
- Leash Trained:_____________________________________________________
- Crate Trained:_____________________________________________________
- Voice Command Trained:____________________________________________
- Special Needs:______________________________________________________
- Current with ALL of the following Vaccinations: Adeno virus (up to 1 year of age), Parvo, Parainfluenza Type I and II, Distemper, Leptosporosis, Canine Influenza, Bordatella and Rabies. ** ALL of these vaccinations must be listed on the Vet records as having a date that is current. You will need to provide a copy of these records that we can keep for our files. It is your responsibility to keep these records updated.
- _____ (Initials) I agree to allow my dog to Co-mingle with other dogs in daycare and those that are coming to shop at the store.
- _____ (Initials) I agree to allow the Staff of MDO to hold my dogs body, in the event of death, until the owner can collect the body by 6pm the day of expiring. I agree to allow the staff of MDO to dispose of my dog’s body, in the event of death, if it can not be collected by 6pm the day of expiration.
- _____ (Initials) I agree to allow the staff of MDO to contact Grand County Animal Control if my dog is left in our care, without owner pickup. The dog will be turned over to Grand County Animal Control in the event of abandonment or aggressive behavior that members of our staff can not control.