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Application

Thank you for your interest in Zipidy Do Dog services.
Please complete our online application to enroll your dog(s)!

Owner Information:

First Name*

Last Name*

Address*

City*

State*

Zip Code*

Email*

Phone 1*:
Please Select Phone 1 Type:

Phone 2:
Please Select Phone 2 Type:

Phone 3:
Please Select Phone 3 Type:

Additional Owners

Additional Owners Names

Emergency Contact Information:

Emergency Contact Name*

Emergency Contact Phone Number*

Dog's Information:

Your Dog's Name*

What Breed Is Your Dog?*

Dog's Birthday (Guess if unknown)*:

Dog’s Gender*:

Spayed/Neutered or unfixed*:

Preferred Veterinarian*

Veterinary Office Phone Number*

VACCINATION INFORMATION:

Rabies Expiration*

Bordetella Expiration*

Combo Expiration*
(Note: Combo vaccinations usually include Distemper, Hepatitis, Lepto, Parvo, Parainfluenza, etc.):

ADDITIONAL INFORMATION:

How long have you owned your dog*?

Where was he/she obtained*?

Has your dog ever bitten any human or dog*?

If yes, please explain:

Is your dog an escape risk*? (Dig, climb, etc)

If yes, please explain:

Is your dog possessive of any food/toys with either human or dog*?

If yes, please explain:

Does your dog have any medical conditions/medications*?

If yes, please explain/list:

Is there any additional information you can add that will assist us in caring for your dog(s)?

Dog Boarding/Daycare Agreement

Zipidy Do Dog refers to both Zipidy Do Dog Daycare LLC and Zipidy Do Dog Resort LLC

1. Owner specifically represents that he or she is the sole and legal owner of the dog(s), free and clear of any liens or encumbrances. Upon signing and admitting dog(s) to Zipidy Do Dog, owner certifies the accuracy of all information given about the dog.

2. Zipidy Do Dog shall exercise reasonable care for the dog(s) admitted by the Owner. Owner recognizes and accepts potential risk involved in the boarding/daycare environment. The Owner fully agrees to accept full responsibility for any and all acts or behavior of Owner’s said dog(s) while in the care of Zipidy Do Dog. It is expressly agreed by Owner and Zipidy Do Dog that Zipidy Do Dog will not be liable for any escape, sickness, injury, or death contracted or suffered while the dog(s) are in the care of Zipidy Do Dog, or thereafter discharged.

3. Owner further agrees to maintain currency of vaccinations as required by Zipidy Do Dog and agrees to withhold dog from daycare/boarding if Owners knows of exposure to contagious disease until written clearance from veterinarian is provided.

4. Owner agrees to pay the rate for the dog(s) care provided and any requested special services in effect the day the dog(s) was admitted.

5. If the dog(s) become ill or injured and requires veterinary services, Zipidy Do Dog, in its sole discretion, may engage the services of a veterinarian or administer medicine or give other requisite attention to the dog, and the expenses thereof shall be paid by owner.

6. All charges incurred by Owner shall be payable in entity upon pick-up of the dog(s). Unpaid charges are delinquent ten days from the date of discharge. Owner agrees that in the event the charges are not paid in entirety when due in accordance with this contract, after ten days, Zipidy Do Dog will place a lien on the dog and dispose of the dog(s) in such manner as sees fit including but not limited to sale of said dog(s) and owner waives all statutory or legal rights to the contrary.

7. Any controversy or claim arising out of or relating to this agreement, or the breach thereof, or as the result of any claim or controversy involving the alleged negligence by any party to this Agreement, shall be settled in accordance with the rules of the American Arbitration Association, and judgement upon the award rendered by an arbitrator may be entered in any court having jurisdiction thereof. The arbitrator shall, as part of the award, determine an award to prevailing party of the costs of such arbitration and reasonable attorney’s fee of the prevailing party.

Check this box to acknowledge you have read and agreed to the terms of our Dog Boarding / Daycare Agreement.