Belt Road Cattery

124 Belt Road Cattery

New Plymouth 4310Email:

Phone: (06) 7584488Web:

BOOKING FORM

Client Details

TitleMrMrsMsDrOther

Name......

Address......

...... Post code ......

Home Phone ( )...... Work ...... Mobile ......

Email......

Booking Dates

Arrival Date:…../…../20… 8am to 10am 4pm to 6pm

Departure Date:…../…../20… 8am to 10am 4pm to 6pm

Please note weekends hours: Saturday morning 8-10am only.

Sunday afternoon 4-6pmonly

Accommodation and Prices

Semi Communal$15 per day

Family Condo$30 per day for 2 cats

$18 per day 1 cat. Peak times $20 per day1 cat

Should your cat need to go into isolation while staying at the catterythere is an additional charge

My Cats Details

Cats Name...... Age (or DOB)......

Sex:MaleFemaleDesexedYesNo

MicrochippedYesNoMicrochip number......

Breed...... Colour ......

Date of your cat’s last vaccination......

Cats PersonalityFriendly / Playful / Indifferent / Shy / Nervous / Unsocial / Difficult / Aggressive with cats

Cats Name...... Age (or DOB) ......

Sex:MaleFemaleDesexedYesNo

MicrochippedYesNoMicrochip number ......

Breed ...... Colour ......

Date of your cat’s last vaccination......

Cats PersonalityFriendly / Playful / Indifferent / Shy / Nervous / Unsocial / Difficult / Aggressive with cats

We will need to see and hold on file, a copy of your cat’s current vaccination record. We do notaccept cats that aren’t fully

vaccinated. They need to have completed their course at least 10 days prior to coming to the cattery.

Food

We provide Hills Science Diet biscuits which is a premium quality, vet recommended biscuit.

If you prefer us to feed your cat with a food of your choice you are most welcome to bring your cats food but we

do not discount for this.

My cat usually eats ......

  • I will provide the above food for my cat YesNo

Your Veterinarian’s Details

Clinic Name......

  • Has your cat had any illness or health issues eg allergies, arthritis, cat flu, sneezing/runny eyes,

heart or kidney problems, ringworm, FIV+etc.(please circle)YesNo

Please provide details......

......

  • Is your cat currently on or recently been prescribed any medication by a Veterinarian: YesNo

Please provide details......

......

  • Should your cat get sick or pass away in your absence would you like to be contacted?YesNo

Emergency Contact Details

In the unlikely event of an emergency and we are unable to make contact with you, please supply the name and contact details of a person authorised to make any decisions relating to the wellbeing of your cat.

Name:...... Address:......

Home Phone ( )...... Work...... Mobile ......

  • In the event that you are unable to collect your cat personally you give Belt Road Cattery your express permission to release your cat to the person named above? Yes No

How did you hear about Belt Road Cattery?......

Microchipping

  • Would you like your cat microchipped while your cat stays with us? (please circle)YesNo

Price $45 (includes registration on the NZ Animal Register)

Payment

If you would like to do internet banking for the deposit please enter your surname and your cat’s name in the reference.

Belt Road Cattery bank account number 15-3949-0452082-10

Balance of payment can be paid when collecting your cat by eftpos, cash or cheque. Credit card transactions

incur a 3% surcharge.

By booking your cat into Belt Road Cattery you are agreeing to our Terms and Conditions and any

changes which are made from time to time.

Signed ...... Date ......

______

OFFICE USE ONLY

Wormed…. /…. / ….Type...... Deflead…. /…. / …. Type...... Last vaccination…. /…. / …. Book sighted Y / N

Items left at cattery ......