New Customer Form – The DogHouse Inn

Name *

First

Last

ABSOLUTELY NO BOOKING will be accepted under ANY CIRCUSTANCES UNLESS THE 50% DEPOSIT (Peak) or $60 (Off Peak) IS PAID AT TIME OF BOOKING. If Booking is less than $100, then $35 must be paid up front. - NOTICE GIVEN more than 15 days prior to entry there is a $100 cancellation fee, which will be deducted from your deposit at PEAK times.

Address *

Address Line 1

City

State / Province / Region

Postal Code

Phone *

Email *

Do you require Boarding or Daycare? *

Boarding
Daycare

Drop-Off Date *

ALL Charges are PER DAY during our OPENING HOURS. eg. Friday to Sunday is 3 days. The first day you will be charged whether you drop of am or pm.

Drop-Off Time *

Monday - Friday 7.00am – 10.30am
Monday - Friday 3.30pm – 6.00pm
Saturday - 8.00am – 10.30am
Sunday - 3.30pm - 6.00pm.

OUR Week-end set rates: $60 (off peak) $70 (peak) for both Saturday & Sunday during opening hours.

Pick-Up Date *

ALL PICK UPS / DROP OFFS OUTSIDE NORMAL OPENING HOURS WILL BE CHARGED AN OUT OF HOURS $30 FEE extra.

Pick-Up Time *

Monday - Friday 7.00am – 10.30am
Monday - Friday 3.30pm – 6.00pm
Saturday - 8.00am – 10.30am
Sunday - 3.30pm - 6.00pm

Dog name/s & DOB / Age? *

Please indicate the name or names of your dogs THEIR DOB & age please?

Sex *

Male
Male (neutered)
Female
Female (neutered)

Breed/s & Colours *

Microchip Number/s (If you know it)

By law all dogs should be microchipped. The

Your Dog/s Weight in kgs please? *

Estimation is fine.

Last Wormed Date *

Any specific requirements or information we should know?

The more we know about your dog, the better we can help make him/her more happy.

Date on the Vaccination Certificate - Please bring original with you on day of drop off, Thank you. *

An up to Date Vaccination Certificate is required. Your dog cannot board with out it.

File Upload

Click or drag files to this area to upload. You can upload up to 3 files.

Please upload a photo or image of your dogs Vaccination Certificate.

Name of your Vet & Phone Number? *

If we need a vet urgently we will call Chinchilla Vets. If you don't want us to call them please let us know.

Permission to Call Vet on your behalf? *

Yes
No

By agreeing and click yes to understand that you will be liable for all expenses.

Any medical condition needing attention? *

Yes
No

Special Needs or Allergies / Medication required to be GIVEN.

All medication must clearly be labeled with Name of Medication, Dog's name and Dosage as prescribed by the vet.

Indicate how social your dog/s are: *

Sociable to both humans & animals, Friendly to people only, Aggressive, Re-active to other dogs, Separation Anxiety, Scared of Storms, Jumps Fences, Chews dog beds.

Emergency contact *

First

Last

Person other than yourself in the case we are unable to contact you.

Emergency contact person's number? *

In the event of an emergency, contact me for....... *

Major incidents Only
All incident NO MATTER WHAT
At Kennel Management Discretion
After you have taken to the Vet
Do what needs to be done 1st for the well being of my dog.

No decisions will be made without consulting the owner first if possible. IF you aren't able to be contact we will try your emergency contact person. You understand that if a snake bite occurs our 1st priority is to get to the vets as quickly as we can to save your dog. We will still try to ring you 1st while we are in transit.

Medical Expense - I agree to pay........ *

Yes, only up to the cost of $1000.00
Yes, up to the vets discretion (no price limit)
No (You have agreed, as the owner to take FULL RESPONSIBLITY FOR ANY INJURY OR DEATH. if something was to occur.

You the owner, waiver your right to hold The DogHouse Inn of all responsibility from calling the vet immediately in an emergency. You immediately recognize & take full responsibility of all outcomes whether good or bad, including but not solely any death or injury to your dog/s especially if time is of the essence.

In case of death: *

Contact me immediatley
Contact my emergency contact
Will discuss on Drop Off
Do not know

Additional Services we Offer? NOTE: These options may not always be available at time of booking. *

Any costs relating to the above will be charged and payment due at time of pickup if they aren't stated when booking form processed. NOTE: We are not GENERAL ANIMAL REMOVALS.

Do you give Permission to take photos, & use in any multi-media format? *

Yes
No

All photos, vidoes, etc are the property of The DogHouse Inn and are not for sale.

Food you will supply & how much do you give your dog: ( please tell us how much food you feed your dog / day.) Include any SPECIAL DIET *

For the well-being of your pet, we only require their dry biscuits which they eat everyday. The reason being that your dog is use to his/her own food, which is comfort to them. Also by not changing there normal food they won't get an upset stomach.

How did you here about us? *

Anything that we should know about your pet to help make his/her stay better here. Please list all items here which you are going to bring along. *

Please reframe from bring toys and bedding and dishes we have heaps of these products for your dog to use. We cannot always guarantee you will get these items back so we ask if you could not bring them along in the first place. (incl colour / size of leads if leaving behind)

I agree to the Terms and Conditions *

I have read, understood and agree to the Terms of Service

DEPOSIT / CANCELLATION POLICY: I understand & accept this as part of the Terms of Service (We strong suggest you read these before submitting). *

ABSOLUTELY NO BOOKING will be accepted under ANY CIRCUSTANCES UNLESS THE 50% DEPOSIT (Peak) or $60 (Off Peak) IS PAID AT TIME OF BOOKING. If Booking is less than $100, then $35 must be paid up front. - NOTICE GIVEN more than 15 days prior to entry there is a $100 cancellation fee, which will be deducted from your deposit at PEAK times. NO REFUND will be given when cancelled less than 15 days from entry date.