Surrey Dog Walking and K9 Campers

Information/Booking Form

Please complete and sign this form prior to your pets service commencing. It can be returned by email, post or by hand.

It’s quite a long form, but if you can answer the questions as fully as possible this will ensure I am able to provide both you and your dog the very best service.

I’ll arrange a meeting with you and your pet either at your house or ours to discuss what type of pet care you are interested in. No obligation meeting. A one hour slot or trial day can be diarised.

I will need to see a copy of your dog’s inoculationscertificate from your vet.

Contact Details

Petsname and Breed

Your name:

Address:

Telephone Home and Work:

Email address:

1.2 x Emergency contact: phone number and address

2.Please state what you would like me to do if for some reason you are unable to collect your pet

3.Your holiday contact no:

Your holiday address/destination:

YOUR PET INFORMATION

Breed:

Age:

Date of birth if known:

Sex:MaleFemale

Has your pet been neutered?

If no, and your pet is female when is her next season due?

Whilst your bitch is in season I won’t walk her with other dogs – this may incur you a price increase as during this time she will require an individual walk.

Is your pet up to date with all its vaccinations/boosters?

Canine distemperyesno

Hepatitisyesno

Leptospirosisyesno

Parvovirusyesno

Is your pet up to date with its worm treatment?Yes no

Is your pet up to date with its flea and tick treatment?Yesno

PLEASE NOTE : We are unable to take any dog into our care that is not up to date with the above vaccinations and treatments. Kennel cough vaccination is also recommended and preferred. Dogs showing signs of kennel cough and contagious conditions will not be accepted.

Does your pet have any medical condition? Allergies?Yesno

If yes, please state:

Please ensure you keep me informed of development of any medical conditions.

Will I be required to administer any medicines whilst your pet is in my care?Yesno

If yes, please state:

PLEASE NOTE: I do not have veterinary skills so only basic medicines will be administered i.e. tabletsor drops into food.

Does your pet have medical insurance:Yes no

If yes, please provide contact details:

Does your pet have any particular behaviouralproblems or not get on with any other particular pet, animal, person? Yes no

If yes, please state:

Does your pet travel well in a vehicle?Yesno

CAR TRAVEL: your dog will probably need to travel to a suitable walk location if there is not one near to where you live and/or to collect other dogs to take out on the same walk – in this case iwill use my air conditioned Vauxhall Zafira. Dogs will travel either in a crate or the boot.

Do you give permission for your pet to travel in my Vauxhall Zafira?Yesno

What type of walk do you normally give your pet - dogs only:

Average length (time wise) or average distance:

Type of terrain (town, pavements, country woods):

Do you tend to walk your dog by itself or with other dogs?

Do you give permission for your dog to be let off the lead:YesNo

Do you accept primary responsibility for your dog?Yes no

Do you have any particular training commands/recall you would like me to use?

If yes please state:

What food does your pet usually eat and at what times:

Is your pet chipped:yesno

If yes, what is your pets registered chip no:

What is the telephone no. of the company your pet is registered with?

Your vets name:

Vetsaddress:

Vetstelephone no:

If your dog urgently needs to see a vet whilst in our care I will endeavourto contact you first and then take it to your own, usual vet. If this is not possible I will take it to the nearest veterinary practice. Are you happy with this arrangement yes no

We are registered with Cobham Park Veterinary Clinic in EffinghamIs it okay if a photo of your pet appears on the K9 Campers website: Yes No

K9 Campers is a family run business and we may occasionally require help from spouse/family members only.

Are you in agreement: Yes No

SERVICE and BOOKING

Which service would you like?

Dog walk

Individual VIP dog walk

Home visit – feed and fuss – dogs, cats, small animals

Puppy play time

Hutch change

Day care @ your house

Day care @ our house

House Sitting

K9 Camping – boarding at our house

Pet Taxi

From when to when, date and time:

Please text or phone one hour before collection and keep us posted of any delays.

Provision of keys, gate codes etc. Please state:

I hereby confirm that I am the owner of the above named pet/s and I authorisethe following, Vanessa Roe of K9 Campers:

To act as guardian during my absence and to take any action which she considers suitable in order to protect and keep in good health the above named pet/s. I do further confirmthat I will be responsible for any costs which might be incurred (veterinary or otherwise)as a result of any sickness, accident or damage caused to or by, the above mentioned, pet/s and that I will pay any such costs or expenses on demand. I further understand that by giving my authorisationthat my pets may be looked after and walked with other pets from other homes. This consent/ confirmation has no expiration date unless otherwise noted and so will remain in effect for all future bookings. A photocopy of the signed confirmation shall have the same force and effect as the client/pet owners original signature.

Bookings are secured with a 50% non refundable deposit and spaces being limited are only reserved once deposits are paid. We operate a first come first served basis. To avoid disappointment we would recommend paying deposits as early as possible as returning customers do book 6-12 months in advance. Full payment is due before start of boarding or on day of arrival. If other costs are incurred by us (vet, food, bedding, leads etc) we will let you know and expect payment upon collection. Payment by cash, cheque or transfer. Please let me know what you prefer. Of particular importance any cancellation on the day is chargeable.

Please note we do not charge per 24 hour period. We charge a daily rate and a night fee. Days of arrival and departure are charged at full day rate.

I confirm that I have read and agree to the Terms and Conditions of K9 Campersyesno

Signature and Date:

Print name:

Please return to: Vanessa Roe, 84 Clare Crescent, Leatherhead, Surrey, KT22 7QZ

Or to: