Kamper Assessment

The information you will provide on these forms is important and will help us understand the needs of your pet. The forms must be completed in their entirety before your pet’s first day of Kamp.

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Parent Information

Owner:*

First* Last*

Address:*

Street* City* State* Zip Code*

Contact:

Cell*

Home

Work

Email Address*

Kamper's Profile

Pet's Name

Age

Color/Markings

Breed

Sex

Spayed/Neutered?

Socialization

Has your pet attended daycare before?

Yes

If so, where did they attend:

Does your pet socialize regularly with other dogs?

Yes

If no, please explain:

Health & Wellness

Vet Clinic Name:

Phone

Does your pet have any physical disabilities?

Yes

If yes, please explain (disabilities):

Does your pet have any known illnesses or injuries we should be aware of:

Yes

If yes, please explain (illnesses):

Is your pet currently on any medication?

Yes

If yes, does your pet need medication administered while in our care?

Yes

Does your pet have any known allergies?

Yes

If yes, please explain (allergies):

Is there anything else we need to know about your pet?

Vaccinations- We require that all Kampers have the following vaccinations (unless otherwise recommended by your veterinarian - must show proof):*

Bordetella yearly intranasal or oral yearly, injectable 6 months

Distemper

Rabies

Leptospirosis

Canine Influenza

Please specify which Flea/Tick prevention your pet is currently using

Training

Is your pet housebroken?

Yes

Is your pet crate-trained?

Yes

Has your pet had formal obedience training?

Yes

Is your pet leash trained?

Yes

Does your pet know basic commands? (check all that apply)

Sit

Down

Stay

Come

Do you use any special commands we should know, specific to your pet?

Yes

If yes, please explain (command):

How would you describe your pet’s recall skills?

How do you discipline your pet?

Are others able to easily handle your pet?

Behavior

What does your pet do when no one is home?

Do you have reason to believe your pet may jump a 5 foot fence?

Yes

Is your pet easily stressed?

Yes

If yes, what are their main triggers? (i.e. fireworks, new environments)

Describe your pet’s personality (check all that apply)

Shy

Mellow

Outgoing

Excitable

Active

Coach Potato

Rambunctious

Anxious

Unpredicatable

Uninterested

Relaxed

Describe your pet’s nuisance behavior, if any. Be honest! (check all that apply)

Excessive Barking

Jumping

Digging

Climbing

Chewing

Mouthiness

Eating stool

Other

If 'Other', please specify:

Has your pet ever bitten a person?

Yes

If yes, what were the circumstances?

Has your pet ever destroyed items in your home? (check all that apply):

Doors/Moldings

Blankets/Pillows

Electrical Cables

Shoes

Furniture

Other

If 'Other', please specify:

Rules and Policies

All pets are required to undergo a pre-arranged social evaluation to assess your dog’s temperament. (Daycare Assessment)

All pets must be leashed while on the property, including the entering & exiting of the building, for the safety of your pet.

Your pet’s acceptance into daycare is at the sole discretion of the North Star Veterinary staff, and may be revoked at any time, due to inappropriate or aggressive behaviors.

We ask that you show up at your scheduled drop-off & pick-up times, or additional charges may be applied at the discretion of North Star Veterinary.

All daycare is pre-booked & appointment only, pending social evaluation approval (Daycare Assessment)

All pet daycare will be paid up-front at the time of drop-off for your pet by either cash or credit card only.

All dogs must be spayed or neutered by the age of 6 months, unless otherwise recommended by your veterinarian (documentation required).

Puppies must be at least 16 weeks of age and have current parasite control and all required vaccinations, administered at least 7–10 days prior to arrival, to attend doggie daycare. These requirements help protect the health and safety of your puppy as well as the other dogs in our care.

Please be aware that it is not uncommon for some pets to have little to no appetite, an excessive appetite, increased lethargy, and/or mild diarrhea during and after their daycare stay. We will monitor these situations closely and advise owners of any such occurrences.

Doggie daycare is not suitable for every pet. If your pet experiences extreme stress or separation anxiety for an extended period of time, we will contact you, or the emergency contact if you are unable to be reached, and arrange for your pet to be picked up.

Owner Agreement*

I agree that I have completed the KAMPER PROFILE FORM and on [behalf of] myself and my pet fully, and correctly to the best of my knowledge I also agree to notify North Star Veterinary of any changes to the information as required.

I agree that I have read and understand the attached RULES AND POLICIES, and agree to be bound by them. I further agree that if I, or my dog does not follow the rules and policies, that it is at the discretion of North Star Veterinary to refuse service to me and my pet.

I understand I am solely responsible for any harm or damage caused by my dog to persons, or property of the owners, staff, volunteers, and invitees of North Star Veterinary, or any other pet(s) housed or visiting North Star Veterinary.

I further understand and agree that North Star Veterinary, and their staff, volunteer, or other agents, will not be held liable for any problems which develop, and I hereby release and discharge them of any and all damages, liability, and/or causes of action of any kind of accident, damage, or injury whatsoever arising from my pet’s attendance in doggie daycare.

I understand, consent, and agree that any problem or injury that develops with my dog while under the care of North Star Veterinary, will be treated by my own veterinarian. In the event my own vet is not available, or too far away (i.e. emergency), I agree to leave the choice of veterinarian at the discretion of North Star Veterinary to treat my dog. I agree to assume full financial responsibility for any and all expenses involved in such treatment.

I understand that during doggie daycare photos and videos of my pet will be taken during their stay. These photos and videos may be posted on the company's websites, Facebook, or other marketing materials and outlets. You provide North Star Veterinary permission to utilize any video or photographs taken of your pet in any future marketing efforts, whether online or in print.

This agreement covers the current terms between North Star Veterinary and yourself, each time you bring your pet to doggie daycare, you affirm the terms of this agreement and the truthfulness and accuracy of the information provided, including any other relevant information not covered in this form.

You authorize us to obtain/verify all medical and vaccination records for your pet from the vet listed above and you authorize your vet to provide these records to us. I also agree to the terms and conditions set forth by doggie daycare, regarding the vaccination and parasite prevention requirements to attend.

I understand that due to the nature of dog play, and general dog interaction, minor cuts and scratches are not uncommon even with careful supervision. In the event the pet has inflicted serious injury, however, I understand and hereby represent that I am solely responsible for any harm caused by my pet while they are attending doggie daycare.

I understand and agree that in admitting my pet to doggie daycare that they are relying on my representation that my pet is in good health, and has not harmed or shown aggression or threatening behavior towards any person or any other dog.

I have initiated each statement above, acknowledging my understanding and acceptance.

I certify that I have read, understood, and agree with the policies of North Star Veterinary, as set forth on the preceding pages, that I have read, understood, and agree with the conditions and statements for this agreement.

Owner Signature:*

First* Last*

How did you hear about us?

SMS Consent

I agree to receive recurring automated messages about pet care, appointment reminders, marketing communications, and offers to the mobile number provided. Your consent is not required, and you may opt out at any time by replying STOP. Msg & data rates may apply. Message frequency may vary.

I agree to receive SMS communications.

Email Consent

I agree to receive marketing offers and updates via your preferred/primary email. You'll still receive services and account related emails if you do not check the box.

I agree to receive email communications.

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