Muddy Paws Dog Walking | Enrolment Form

Please read this form and the accompanying Terms and Conditions carefully (this level of detail is required to ensure we can provide the highest level of care and safety for your dog). Then complete and sign this form (including acceptance of the Terms and Conditions, Off the Lead Consent Form and Waiver of Liability).

General Information

Your Name Address Postcode Email Address Phone: Home Mobile Work Partners:

Name

Phone: Home Mobile Work Emergency Contact Vet Vet Address Postcode Phone

Security Information

Gate Codes Alarm Instructions

Your Dog's Details

Name Age Gender (M/F) Breed Colour Is Your Dog Microchipped? (Y/N) No Is Your Dog Insured? (Y/N) How Long Have You Owned Your Dog? Please briefly describe your dog's history (e.g. if adopted)

Date Of Last Immunisation

Neutered? Yes

No but will be by

Un-Neutered Bitch?

Date of Last Season

Up To Date With Shots? Yes

No but will be by?

Date of Last Kennel Cough vaccination (Bordetella)?

Allergies:

Please list any pre-existing or current health conditions Please list any medication your dog is currently taking and instructions Please indicate if your dog has any sensitive areas on his/her body Please describe any restrictions on your dog’s activity (e.g. due to physical limitations such as hip dysplasia) Is your dog allowed treats while under the care of Muddy Paws?

Social Skills

Please give a brief description of any formal obedience training your dog has received How does your dog react to other people and dogs when on walks?

Behaviour

Please describe general behaviour and energy levels (both inside and when out)

Please provide details if your dog is anxious around, or frightened by, any of the following:

Noises Actions Objects Breeds or Types of Dog Types of People Where does your dog sit when travelling in the Car? Front? Back? Boot? Does your Dog ever get car sick? Does your dog have specific command to "go to the bathroom"? Does your dog behave differently on and off lead? Does your dog play off lead with other dogs? Does your dog live with children? How does your dog behave around new children? How does your dog behave around livestock? Has your dog ever jumped on someone (if so, please describe the circumstances)? Has your dog growled or snarled at someone (if so, please describe the circumstances)? Has your dog ever bitten someone (if so, please describe the circumstances)? Has your dog ever bitten another dog, other than play-biting (if so, please describe the circumstances)? Does your dog allow you to take things out of his/her mouth? What type of dogs does your dog prefer to socialise with (e.g., small, females, playful, calm, etc.)?

Routine

Please describe pick up and return routine Please give any other information that you think would be useful to enable us to give your dog the best possible care while under the care of Muddy Paws Dog Walking

Disclaimer & Waiver of Liability:

The information I have given in this application is true, correct and complete to the best of my knowledge.

I have read and agree to abide by the Terms and Conditions for services received from Muddy Paws Dog Services. I hereby indemnify Muddy Paws Dog Services and their staff against liability of any kind whatsoever arising from my dog’s participation in any services offered by Muddy Paws Dog Services.

Full Name Date

Please tick to accept our terms and conditions

Please attach copies of your dog’s most recent vaccination certificates, including kennel cough (bordetella)

Off the Lead Consent Form:

I agree to Muddy Paws Dog Services having the right to allow my dog off the lead and understand that all terms and conditions remain the same.

Full Name Date

Please tick to accept our terms and conditions

Key Holder Disclaimer & Waiver of Liability:

The information I have given in this application is true, correct and complete to the best of my knowledge.

I have read and agree to abide by the Terms and Conditions for services received from Muddy Paws Dog Services. I understand that this form acts as permission to hold keys to my property, which I have provided willingly. I hereby indemnify Muddy Paws Dog Services and their staff against liability of any kind whatsoever arising from damage or loss of any property.

Full Name Date

Please tick to accept our terms and conditions

Terms of Business can be viewed here.