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A Home Away From Home for Your Best Friend

New Client Form

Before your dog’s first stay or daycare visit, we ask that all new clients complete this form in full. This helps us get to know your pet, their needs, and how we can provide the best possible care during their time with us. Thank you!

You will be contacted first. Emergency contact is if I cannot get ahold of you. Preferably someone who is nearby that can pick the dog up, etc.

Dog's Gender
Spayed/Neutered?

To ensure the safety of all pets and employees at Church Road Kennels we require the following vaccinations to be up to date prior to your dog's stay.


Rabies

Bordetella (Kennel Cough)

DHPP (Distemper, Hepatitis, Parainfluenza, Parvovirus)


Your dog is staying in our home and sharing areas that our own dogs/other client's dogs use, so we also require your pet to be on flea/tick prevention between the months of April-October. Failure to disclose a flea/tick problem prior to arrival may result in refusal of future services. Also, if your dog is observed to have fleas or ticks, they will be separated and will need to be picked up immediately.


I understand the above information and agree to comply with all requirements.

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If none type N/A.

If none type N/A. If yes, please type names of medications, dosage, how many times a day, and how you administer them.

If none type N/A.

Can your dog have treats?
If your dog is in a kennel with another one of your dogs, can they be fed together?
Is your dog friendly with other dogs?
Has your dog ever shown aggression?
Is your dog afraid of thunderstorms or fireworks?
Has your dog ever tried to jump a fence?

Media Consent

I consent to Church Road Kennels taking pictures and/or videos of my dog during their stay. These may be shared on social media platforms or used for promotional purposes.

Veterinary Care Authorization

In the event of illness or injury, I authorize Church Road Kennels to seek veterinary care for my dog at their discretion. I understand this may not be at my dog's usual vet due to distance or needing a 24-hour vet hospital. I understand that I will receive a phone call to make decisions for my dog's care, but if I do not answer then my emergency contact will be called. I understand that I am responsible for all veterinary expenses incurred as well as costs for the transportation, and agree to reimburse Church Road Kennels if they advance payment for treatment. This authorization will be in effect and cover future boarding dates as well, unless owner revokes authorization or requests new agreement.

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Elderly Dog Agreement

I understand if I have an elderly dog (approaching the end of life) that is staying at Church Road Kennels and the dog passes while in their care, I will be immediately notified and my dog will be transported to my vet clinic if within a reasonable distance and will be held there until the vet reaches me for further instructions. If my vet is closed or far from Church Road Kennels, then my dog will be transported to the nearest 24-hour vet hospital instead.

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Owner Agreement

I confirm that the information provided above is accurate. I understand that while every effort will be made to ensure safety and well-being of my dog, Church Road Kennels is not liable for illness, injury, or death due to pre-existing conditions, age, or unforeseen incidents during boarding. I understand and agree that I am responsible for any harm that my dog causes to any other dogs, people, or property in the facility or on the property of Church Road Kennels. I will cover all costs and reparations that result from the actions of my dog. I understand if my dog shows aggression towards other dogs or employees that Church Road Kennels has the right to dismiss my dog immediately and I must provide someone to pick the dog up at this time. This agreement will be in effect and cover future boarding dates as well, unless owner revokes or requests new agreement.

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Dog Outdoors
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