Location

Please select which location you require.

Cowdenbeath

Glenrothes

Days required

Monday

Tuesday

Wednesday

Thursday

Friday

Ad hoc basis

Transportation Required

Collection

Drop Off

Name *

First Name

Last Name

Name

First Name

Last Name

Date Of Birth (If known)

MM

DD

YYYY

Sex

Male

Female

Vaccinated/ Titre Tested

Yes

No

Date of last vaccination/ titre test

MM

DD

YYYY

Date of last Worming Treatment

MM

DD

YYYY

Date of last Flea Treatment

MM

DD

YYYY

Neutered

Yes

No

Insurance

Yes

No

How Is Your Dogs Recall?

VERY GOOD (responds and recalls quickly in most situations)

GOOD (comes back most of the time)

MODERATE (can take a while to respond but recalls eventually)

POOR (doesn't respond)

Date Of Birth (If Known)

MM

DD

YYYY

Sex

Male

Female

Vaccinated/ Titre Tested

Yes

No

Date of last vaccination/ titre test

MM

DD

YYYY

Date of latest Worming Treatment

MM

DD

YYYY

Date of latest Flea Treatment

MM

DD

YYYY

Neutered

Yes

No

Insurance

Yes

No

How is your dogs recall?

VERY GOOD (responds and recalls quickly in most situations)

GOOD (comes back most of the time)

MODERATE (can take a while to respond but recalls eventually)

POOR (doesn't respond)

Emergency First Aid Permission

By ticking this box, I hearby give my permission to allow Geopaw Premium to carry out any emergency first aid procedures as deemed necessary for the safety & welfare of my dog(s) prior to immediate consultation by a veterinary professional in order that they receive the best and most appropriate care as soon as possible. I also give my permission for my dog(s) to be given any drug prescribed by my vet as required in my absence, & agree that I have confirmed with them that Piriton antihistamine may be administered safely for the treatment of allergic reactions.

Off Lead Permission

*New dogs may be kept on lead or a long training line. This allows me to assess your dogs recall and also interaction with the group. There is always the possability your dog may not fit into the group, in such circumstances your dog will have a solo walk.

By ticking this box, I allow my dog(s) to be let off lead.*

Photography / Video

I hereby grant & authorise Geopaw Premium the right to take, edit, alter, copy, exhbit, publish, distribute, & make use of any & all pictures & video taken of my dog(s). To be potentially used in and/or for any lawful promotional materials including, by not limited to: flyers, posters, social networking sites, website and other print and digital communications without payment or any other consideration.

Has your dog(s) been in boarding / kennels or stayed away from you before?

Yes

No

Is your dog crate trained?

Yes

No

Does your dog pull on a lead when out for walks?

Yes

No

Jump onto furniture?

(Sofa, tables etc...)

Often

Occasionally

Never

Jump up at people?

Often

Occasionally

Never

Bark or Whine?

Often

Occasionally

Never

Scratch at carpets or doors?

Often

Occasionally

Never

Does your dog(s) mess or urinate in the home?

Yes

No

*

You will present your dog(s) for day care in a clean and groomed condition and with up to date vaccinations/ titer test, de-flea and anti-worming treatments. You will need to supply the necessary dog food and treats for the duration of the stay. If additional food or treats are required you agree, upon presentation of a receipt, to refund GEOPAW Premium Day Care. Any dog(s) attending Day Care with GEOPAW Premium must have a trial introduction period with our own resident dogs. No dog(s) will be accepted without a current vaccination or titer testing certificate. You agree that if you instruct GEOPAW Premium Day Care to exercise your dog off the lead you accept full liability for any loss or damage caused as a result of your dog being off the lead. In the event that your dog attacks a person or a dog or in the event that he/she is involved in a fight with another dog/person causing any damage or injury you agree to be responsible for any losses incurred including payment of veterinary fees or any medical treatment required. We are unable to accept bookings for a dog subject to the terms of the Dangerous Dogs Act 1991 or any other dogs with aggression problems towards other dogs and/or people. Reasonable efforts will be made to contact you in the event of an emergency. However, GEOPAW Premium Day Care reserves the right to make decisions regarding your dog’s health provided it is at all times acting in the best interests of the dog(s) and on the advice of a veterinary surgeon. If your dog(s) becomes unwell, has an accident or injures himself/herself or seems to be in any type of pain, we might need to take him/her to a veterinary surgeon and you agree to be responsible for payment of all the veterinarian fees incurred. GEOPAW Premium will attempt to take your dog to your own vet, however, if this is not possible, our primary local vet ‘Ingils Veterinary Hospital, in either Cowdenbeath or Dunfermline.’ will be used. You undertake to make full disclosure of any quality or characteristic which might make your dog not suitable for home boarding, including, but not limited to behavioural or health problems, anti-social behaviour including aggression, incontinence/lack of housetraining or excessive loud barking/whining. Failure on your part to disclose any matter which might render the dog unsuitable for day care will be deemed a material omission amounting to a fundamental breach of this agreement. You will also be liable for additional costs if GEOPAW Premium Day Care experiences difficulties due to failure to disclose in the booking form any matter that would be accepted as reasonably unsuitable for day care. Geopaw Premium promotes & practices modern positive reinforcement, force free training methods. We will never in any case use or recommend the use of any adverse methods or tools such as e-collars, prong collars, choke chains, slip leads etc. I confirm that I am the owner of the above mentioned dog. I have understood and agree to the above terms and conditions. I also confirm that the information supplied is correct and that any additional information that GEOPAW Premium Day Care should be aware of is also supplied and GEOPAW Premium Day Care will be made aware of any changes.

I agree to terms & conditions