Country Bound Pet Resort - Pet Application

Guardian/Owner's name_______________________________________________

Address______________________________________________________________

Home Phone #(____)___________ Cell#(____)___________Cell(___)__________

Email address________________________________________________________

Pet's name___________________________________ dog/cat_________________

Breed_____________________________ Sex _________ Color________________

Is pet spayed or neutered____________

Allergies:___________________________ Special needs_____________________

Veterinarian Name:___________________________________________________

Phone #(______)____________ Address___________________________________
*** For your pet to have the best vacation ever we would like to get to know
them well, please answer the following questions***
Canine Behavior Questions:
Is there any PERSON, type of DOG, or situation your dog seems to have a problem with?_________________________________________________________
How long have you had your pet?_______________________________________
Where did you get your pet?____________________________________________
Has your dog ever growled at or bit another person or Dog?_______________
Does your pet becomes aggressive around food time?_____________________
Will your pet readily share toys with other dogs?________________________
Has your dog ever jump/climbed over a 6' fence?_________________________
Are there any areas on your dog's body where they do not like to be touched by humans?___________________________________________________________
Any restrictions that should be placed on your dog's activities?______________
_______________________________________________________________________
What else should we know about your pet?________________________________
_______________________________________________________________________
Medications: Yes / No (please list all)
medication_____________________________ dosage_________________________
medication_____________________________ dosage_________________________
Feedings: client provided- Brand Name___________________________________
Morning: Quantity:___________________ Special Instructions______________
Afternoon: Quantity:___________________ Special Instructions______________
Evening: Quantity:___________________ Special Instructions______________
Emergency Contact Name (someone not traveling with you)________________
Home Phone # (____)__________________ Cell # (____)______________________
Persons authorized to Drop off/Pick up my pet/pets_________________________
________________________________________________________________________
I agree to release any/all of my dog's image(s) in video or photo to Country Bound Pet Resort for local, national and/or World Wide Web (internet) for marketing. For use, reuse, and/or publishing and republishing. This is binding upon me and my heirs, legal representations and assigns.

Valuable and Personal Property: Country Bound Pet Resort is not liable to you for your canine/feline personal property damaged, lost, or stolen while on the premises. If your canine/feline causes damage to Country Bound Pet Resort facility/equipment you as the owner are liable for the full cost of repair.
Late Fees: Checkout time is at 11:00 am, pets here longer will be charged for a full day stay at the current price.
Returned checks / Non sufficient checks will be assessed a $25.00 fee.
Guardian / Owner Name ( Print) ______________________________________
Guardian / Owner Signature_____________________________________________________________
Date:________________________