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Name *

First

Last

Email Address: *

Address: *

Phone Number: *

How did you hear about us?

• Google Search
• Word of Mouth
• Social Media
• Drive By
• Other

Emergency Contact (non-owner) *

First

Last

Emergency Contact Phone Number *

Dogs Name *

Breed/Breed Mix *

Age/Birthday of Dog *

Sex (Female/Male) *

• Female
• Male

Spayed/Neutered *

• Spayed
• Neutered
• Intact

Microchipped or Tattooed *

• Yes
• No

License Number with Alberta or Other Province

Is Your Dog Good with Bedding? Choose All That Apply *

• Good with all bedding
• Good with only blankets
• Good with padded bedding
• Not good. Tendency to chew destroy bedding
• Tendency to be destructive when unsupervised
• Needs a raised kuranda bed
• Other

Does Your Dog Have Any Health Conditions?

Medications or Special Care Instructions We Should Be Aware Of?

Behavior & Security *

• Is your dog allowed in supervised group play?
• Does your dog have any history of aggression with people or dogs?
• Has your dog ever attempted to escape? (eg. climbing fences, digging holes, bolting through doors, chewing through crates, etc.?
• Does your dog have bad recall?
• My dog is a CHAMP and has no issues as far as behavior or security.

Check box if answer is YES

Behavior & Security: Please explain any further detail about the above incident

Please be honest as it will help us to better care for your pet

Behavior & Security: Does your dog have any triggers? *

• Food Aggression
• Personal Space
• Toys
• Towards People / Emotions
• Not Good with Other Dogs
• No Triggers

What is your dogs play style?

Running, chase, fetch, sniffing, wrestling, other...

Anything else we should know about your dog?

Second Dogs Name

Breed/Breed Mix

Age/Birthday of Dog

Sex (Female/Male)

• Female
• Male

Spayed/Neutered

• Spayed
• Neutered
• Intact

Microchipped/Tattooed

• Yes
• No

License Number with Alberta or Other Province

Is Your Dog Good with Bedding? Choose All That Apply

• Good with all bedding
• Good with only blankets
• Good with padded bedding
• Not good. Tendency to chew destroy bedding
• Tendency to be destructive when unsupervised
• Needs a raised kuranda ben
• Other

Does Your Dog Have Any Health Conditions?

Medications or Special Care Instructions We Should Be Aware Of?

Behavior & Security

• Is your dog allowed in supervised group play?
• Does your dog have any history of aggression with people or dogs?
• Has your dog ever attempted to escape? (eg. climbing fences, digging holes, bolting through doors, chewing through crates, etc.?
• Does your dog have bad recall?
• My dog is a CHAMP and has no issues as far as behavior or security.

Check box if answer is YES

Behavior & Security: Please explain any further detail about the above incident

Please be honest as it will help us to better care for your pet

Behavior & Security: Does your dog have any triggers?

• Food Aggression
• Personal Space
• Toys
• Towards People / Emotions
• Not Good with Other Dogs
• No Triggers

What is your dogs play style?

Running, chase, fetch, sniffing, wrestling, other...

Anything else we should know about your dog?

Submit

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