Pre-Register

Pet #1 Information:

Name: *

First

Name: *

Last

Age: *

DOB: *

Weight: *

Gender of Pet *

Choose an Option: *

Breed: *

Color/Markings: *

Allergies: *

Pet #2 Information:

Name:

First

Name:

Last

Age:

DOB:

Weight:

Gender of Pet

Choose an Option:

Breed:

Color/Markings:

Allergies:

Pet #3 Information:

Name:

First

Name:

Last

Age:

DOB:

Weight:

Gender of Pet

Choose an Option:

Breed:

Color/Markings:

Allergies:

Owner Information:

Name: *

First

Last Name: *

Last

Address:

Street Address

Address: *

City, State ZIP Code

Home Phone: *

Cell: *

Work: *

Email: *

Cellular Carrier: *

Persons authorized to pick up your pet(s): *

Separate each with a comma...

Does your dog(s) have a tendency to chew things?: *

Emergency Contact:

(responsible for decisions if owner not available)

Name: *

First

Last Name: *

Last

Home Phone: *

Cell: *

Work: *

Vet Information:

Vet Clinic: *

Phone: *

Veterinarian Name: *

Will your pet need vaccinated prior to coming to Paws-a-Palooza? *

Yes

No

Is your pet on flea/tick prevention treatment? *

Yes

No

Is your pet on heartworm preventative medication? *

Yes

No

Day Camp / Boarding Questions:

1) Do you plan on using our day camp service when it opens? *

Yes

No

If yes, how often might you use this service? *

If yes, how long, generally, would your pet be at day camp? *

2) Do you plan on using our overnight boarding service when it opens? *

Yes

No

If yes, would you be boarding more than 1 dog each time? *

Yes

No

If yes, would you want all the dogs boarded in the same suite? *

Yes

No

How often do you currently use a dog boarding service? *

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Pre-Register

Keep in mind, Dogs need to be flea/tick treated at least one week prior to arriving at Paws-a-Palooza. No exceptions. Questions? Contact Us

Prefer to fill out the form on paper?

View Printable Version

Pet #1 Information:

Pet #2 Information:

Pet #3 Information:

Owner Information:

Emergency Contact:

Vet Information:

Day Camp / Boarding Questions:

Questions/Issues? Contact us!