Canine Lane Daycare and Learning Centre | New Client Registration Form

Canine Lane Daycare and Learning Centre New Client Registration Form

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Please complete the form below to the best of your ability. We will be in contact shortly to schedule an evaluation with you. You will then receive our general waiver as well as our policies agreement to sign prior to our evaluation appointment.

Owner Information

First Name *Required*

Last Name *Required*

Phone Number *Required*

Email *Required*

Address *Required*

City *Required*

State | Province *Required*

Zip Code | Postal Code *Required*

Family Vet Clinic *Required*

How did you find us? *Required*

Emergency Contact (Include Phone Number)/Others Allowed to Pick Up *Required*

Owner Question #1: Are you looking for daycare services? Please indicate which days of the week you require. *Required*

Owner Question #2: What personality traits describe your dog best? (ie,shy, goofy, playful, pushy, nervous, excitable) *Required*

Owner Question #3: Has your dog participated in (previously or presently) daycare/group play with other dogs? *Required*

Pet #1 Information

Pet Name *Required*

Breed (Best Guess) *Required*

Sex *Required*

Color Description *Required*

DOB *Req*

Vaccine Expirations

Important: All dogs require proof of vaccinations before they attend our facility. This is for the safety of all the pups and is mandated by our insurance.

Rabies

DPP

Bordetella

Vaccine #4

Vaccine #5

Microchip Code *Required*

Weight *Required*

Insurance Info *Required*

Feeding Notes *Required*

Medication Notes *Required*

Temperament Notes (Aggression, anxiety, etc? If extensive, tell us in person). *Req*

Additional Notes (Anything else we should know? If extensive, tell us in person.)

Pet Question #1: How well does your dog walk on leash? *Required*

Pet Question #2: Is your dog social with both small and large dogs? *Required*

Pet Question #3: Does your dog exhibit any signs of separation anxiety? (ie, howling, whining, barking excessively)

Pet Question #4: Does your dog exhibit any behaviours you are concerned about?

Pet Question #5: How much exercise does your dog receive daily on average? What type/when?

Mobile Phone Alert: Some phones have difficulty uploading the files below (the form gets reset after uploading). If this happens on your phone, please submit this form using a computer. You can also submit this form on your phone without uploading anything and then email your pet picture and vaccine verification document to us at cindy@caninelanedogs.com. Thanks!

Pet Photo (Not Required. 5MB Max. Image Files Only)
Click to Upload Pet Picture

Proof of Vaccinations (5MB Max. Only Images, No PDFs. Take a Picture of Document with Your Phone and Upload It.)

Click to Upload a Picture of Proof of Vaccinations

Click Here to Add a Second Pet

Pet #2 Information