B. Grooming Services Requested (Must schedule pick up time)

     _______ Bath/brush/nails - Includes: Bath; brush out; shave sanitary areas, pads and feet; clean ears; express anal glands. Can be provided any pick up day if pick up after 12:00 pm noon. Large or full coated      dogs, or multi-dog households may require a later pick up time.

     _______ Full grooming including haircut (Appointment required) - Includes all above plus a breed specific or selected style haircut/trim.

C. Walks/playtime/group play - sessions may be scheduled with an additional charge of $3.00 for each session each day. Select type of session and number of times for each type of session each day up to a total      of four times each day.

    Walks at $3.00 per walk per dog:     ________ One time per day _______ Two times per day

    Private Play Time at $3.00 per session per dog:     ________ One time per day _______ Two times per day

    Group Play Time at $3.00 per session per dog:     ________ One time per day _______ Two times per day

    Other (Every other day, 3x, 4x) ______________________________________________________________

D. Items you are leaving this time (Items may not be returned or returned damaged).
     _____ Owners food (please bag each meal)
     _____ Owners food container
     _____ Bedding (describe: ___________________________________________)
     _____ Toys (describe: ______________________________________________)
     _____ Treats (approximate number per day _____________________________)
     _____ Medication (list name of drug, quantity per dose, and number of doses each day)
     _____________________________________________________________________________________________
     _____________________________________________________________________________________________

E. Any special instructions for this stay? New feed, medical issues, allergies?

F. Emergency Contact Information: where you can be reached? ____________________________________

Please read and acknowledge the following policies:

• Normal hours of operation for drop off and pick up are 8:00 am to 8:00 pm
• Special holiday hours may be in effect, please inquire
• We charge for each calendar day the pet is here, not 24-hour periods.
• You will be charged for the day of drop off and day of pick up regardless of the time
• Payment is ALWAYS due in full at the time of pick up.
• We accept cash, check, or traveler's check
• WE DO NOT ACCEPT CREDIT OR DEBIT CARDS OF ANY KIND
• There is a $25 charge for all returned checks
• Pets are only released to the owner unless otherwise specified. If someone else will be authorized to pick up your pet please write their name here: __________________________________________

Signature ________________________________ Date __________