Owner Information

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Phone *

How did you hear about us? *

Pet Information

Pet Name *

Age *

Breed *

Color *

Gender / Altered? *

Male
Female
Neutered Male
Spayed Female

Please tell us the sex of your pet (if known), and if spayed or neutered.

Preventatives

Please list monthly flea, tick, and heartworm preventative products that you administer to your pet, if applicable.

Date Preventatives Last Given

Has your pet been in a daycare setting before? *

Yes
No

Has your dog had any obedience training? *

Yes
No

Does your dog mind being in a large cage/dog run during rest periods? *

Yes
No

Does your dog have any health issues? *

Describe any new or ongoing health issues we should be aware of while your dog plays.

Does your dog display fear around specific people, dogs, or situations? If so, explain. *

Describe any fears that may cause your dog to be reactive.

Describe any other concerns we should be aware of while your dog plays with us. *

Any other health or behavioral concerns should be noted here.

Other Services

Would you like a bath, nail trim, ear cleaning, or other veterinary services during daycare? If so, please list.

Vaccination History

Click or drag a file to this area to upload.

If you have updated vaccination records for your pet, please upload them here.

Emergency Contact Name *

First

Last

Emergency Contact Phone *

Additonal Emergency Contact Name

First

Last

Additional Emergency Contact Phone

Consent
In exchange for the participation in the activity of dog park play at The Radnor Dog Club, and/or use of property, facilities and services of Radnor Veterinary Hospital, I agree for myself and (if applicable) for the members of my family, to the following:

I agree to observe and obey all posted rules and warnings and further agree to follow any oral instructions or directions given by RVH, or the employees, representatives or agents of RVH.
I understand that there are certain inherent rules associated with off-leash dog park activity, and I assume full responsibility for personal injury to my dog(s), and further release and discharge RVH for injury, loss or damage out of my or my family's use of the facilities of RVH, whether caused by the fault of myself, my family, RVH or other third parties.
I agree to indemnify and defend RVH against all claims, causes of action, damages, judgments, costs or expenses, including attorney fees and other litigation costs, which may in any way arise from my dog's use of or presence upon the facilities and services of RVH.
I agree to pay for all damages to the facilities of RVH and those employed and enrolled there caused by my dog's negligent, reckless or willful actions.
I understand that in case of emergency or injury, RVH will try to reach me immediately. If medical attention is necessary, my dog(s) will be treated at the facility and I will be held financially liable for the fees incurred.
Any legal and equitable claim that may arise from participation in the above shall be resolved under Pennsylvania law.
I understand that if my dog displays any inappropriate behavior such as biting or growling, my membership may be canceled in order to provide a safe environment for The Radnor Dog Club Staff and the other dogs within our facility.
I also understand that if my dog shows any signs of illness, such as a cough or parasite infection, (fleas) he/she will be removed from the play area and kept in a cage/run until myself or my other contact can pick up my dog.
I understand that if I do not pick up my dog by close of business at 6pm, my dog will be taken care of overnight in the boarding facility, and I will be charged for an overnight stay in a run/cage of the appropriate size for my dog.
I understand that photos/video may be taken of my dog while they are on The Radnor Dog Club/Radnor Veterinary Hospital's property. These photos may be of my dog only, or my dog with a group of others. I understand that these photos may be posted on social media outlets for The Radnor Dog Club (including Facebook and the business website) for the public to enjoy.
Payment is expected at the time services are rendered. All charges must be paid in full prior to discharge. We accept cash, personal checks, Mastercard, Visa, Debit, Discover and American Express. Please make checks payable to Radnor Veterinary Hospital, LLC. We reserve the right to refuse any personal check, and we do not post-date checks. There is a $40.00 returned check fee. Collection actions are actively pursued by Radnor Veterinary Hospital outstanding for longer than 30 days. Balances over 30 days accrue service charges at a rate of 1.5% per month.

I have read and agree to the requirements detailed above for all of my pets boarding at Radnor Veterinary Hospital.

Radnor Dog Club Daycare Registration Form