Save time and complete your day camp form online! Client Name* First Last Email* Address Street Address City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Home Phone*Cell Phone*Emergency Contact (Name and Number)Who else has authorization to pick up your dog from us?Any additional comment we should know?Dog Name*Breed*Dog’s Birthday/Age*Dog’s Weight*Dog's Color*Spayed or neutered?*Spayed FemaleNeutered MaleNot spayed or neutered (req. at 6 months)Where did you acquire your dog?*BreederRescue ShelterFriend/NeighborFoundOtherHow long have you had your dog?Is your dog on flea and tick prevention?*YesNoWhat preventative medicine do you use on your dog?Has your dog ever been to a doggie day camp program?*YesNoWhere?*Does your dog attend dog parks?*YesNoDoes your dog live with any other pets?*YesNoDoes your dog live with any other pets?Does your dog display leash aggression?*YesNoDoes your dog display separation anxiety?*YesNoIs your dog crate trained?*YesNoIs your dog food aggressive?*YesNoDoes your dog get protective over anything?*YesNoPlease explain:Has your dog ever been in a dog fight?*YesNoPlease explain:Has your dog ever bitten another person?*YesNoPlease explain:Is there anywhere on your dog’s body he/she doesn’t like to be touched?*YesNoPlease explain:Does your dog fear anything?*YesNoPlease explain:Does your dog tend to get into foreign objects?*YesNoPlease explain:Does your dog like to play with any size dog?*YesNoWill your dog jump fences or barriers?*YesNoHas your dog taken any training classes?*YesNoWhat type of training?What commands does your dog know? (Check all that apply) Name Come Sit Stay Release Down Leave It Wait None Others Please list all others.Health History: (check all that apply) Surgery Food Allergies Ear Infections Seizures Kennel Cough Skin Allergies Eye Infections Bloat Other Please explain any health conditions listed above:PhoneThis field is for validation purposes and should be left unchanged.