Registration Form

Owners Name:_________________________________________

Address:_______________________________________________

Home Phone: ________________    Work Phone: _______________

Emergency Contact:________________________ Phone:_______________

Veterinarian______________________________ Phone:________________

How did you hear about us? _____________________________________________

CAMPER INFORMATION

Pet Name:___________________ Sex______  Neutered/Spayed?_____  DOB:________

Breed: _____________Color:_______________ Weight:________

* Home Diet (Brand)_____________ Home Feeding Time(s):__________ Amt._______

*Medications:____________________________________________________________

Dogs: DHLP exp___/___/____                 Cats:      FVRCP___/___/___

        Rabies exp: ___/___/____                        Rabies exp: ___/___/____

  Bordatella exp: ___/___/____                        Leukemia exp:___/___/____

(copy of vet papers required)

_________________________________________________________________________________

Pet Name:___________________ Sex______  Neutered/Spayed?_____  DOB:________

Breed: _____________Color:_______________ Weight:________

* Home Diet (Brand)_____________ Home Feeding Time(s):__________ Amt._______

*Medications:____________________________________________________________

Dogs: DHLP exp___/___/____             Cats:        FVRCP___/___/___

        Rabies exp: ___/___/____                       Rabies exp: ___/___/____

  Bordatella exp: ___/___/____                        Leukemia exp:___/___/____

(copy of vet papers required

_________________________________________________________________________________

Additional Services (please check): NOTE: Additional charges apply.

____ Bath             ­­­­____ Playtime       _____ Pet Delivery/Pick-up

____ Groom          ____ Walking       _____ Cot Rental       _____ Yappie Hour

____Day Care      ____ Photos          _____ Chillie Paws

Please give us any information about your pets that will help make his/her camping experience a pleasant one that she/he will look forward to returning to in the future. (If you need more space, please use the other side of this registration form).

Arrival Date: ___/___/___    Arrival Time:_______ (am) (pm)

Departure Date:___/___/___ Departure Time:_______ (am) (pm)

Deposit Amount: $___________ Owners Signature___________________________

Please make checks payable to “Camp Yuppie Puppy.”  Thank you, we will look forward to your visit with us.

• If you plan to bring your own food for your pet, please put it in pre-portioned ziploc bags. If you have a container you wish to be returned, please put your pets first and last name on the container.

• if your pet is on a medication please be sure to have it clearly marked with pet’s name, dosage and frequency.