Application Form Application Form PERSONAL DETAILS Your Name: (required) Address: (required) Mobile No: (required) Home No: (required) Email: (required) EMERGENCY CONTACT Contact Name: (required) Contact Mobile No: (required) DOG’S DETAILS Name: (required) Sex: MaleFemale Age: Breed: Date of Birth: Allergies: (required) Vet: Contact Number: Annual Vaccination Date (C5): Desexed: YesNo Please provide details of your dog’s personality type, their likes or dislikes or any other details we should know about: Please read and indicate that you agree to the following terms and conditions: THE K9KIDS DOG CARE PROVIDERS AGREE THAT: We will take every care in providing a clean and safe environment for your pup. We will supervise, entertain and cuddle your dog throughout the day. We will contact you in the event of injury or sickness. AS THE DOG OWNER, PLEASE READ THE CONDITIONS BELOW AND INDICATE AT THE BOTTOM OF THIS PAGE AS CONFIRMATION OF YOUR AGREEMENT WITH THE CONDITIONS. I understand that if my dog is not suitable or becomes aggressive at any time, that K9Kids have the right to refuse any future care. I understand that K9Kids reserves the right to refuse any dogs into their care at any point in time. I understand that I must provide proof of vaccination and desexing for a dog to be admitted to K9Kids. I understand that whilst every care is taken by K9Kids staff, that in the event of illness or injury and I am not contactable, that my dog will be taken to a vet for treatment and I am responsible for the full expenses of that treatment. I understand that my dog will not be allowed to day care with fleas. I understand that I must inform staff of any pre-existing condition that my dog may have. I understand that my dog will not be accepted to day care if he is displaying any form of illness eg. kennel cough, influenza, vomiting or diarrhoea. If any symptoms are evident during the day, I will be contacted to collect my dog. I understand that I will be charged a late fee if my dog is not picked up by 6:30pm. I have read and agree to these terms and conditions.