Day Care Application

Please fill out one application for each dog. We require that you have an up-to-date vaccination or titer test showing antibodies to the following diseases: Distemper, Parvovirus, Bordetella, and Rabies. The city of LA also requires us to keep on hand certain paperwork.

Therefore, please bring copies of each of the following to your evaluation:

Receipt or other proof from vet showing Distemper, Parvo and Bordetella vaccinations were given, and/or titer tests showing antibodies to each.
Rabies vaccination certificate
Sterility certificate (spay or neuter)
Current license
Complete medical records for any ongoing medical issues

Basic Info
Your Name(s)*
Please list all owners
Name of Dog*
Dog's Breed*
Dog's Gender*
- Male
- Female
Weight*
Please use pounds. Numbers only.
Color*
Dog's Birthday*
Please estimate if not sure
Housebroken*
- Yes
- No
Spayed or Neutered?*
We only allow unfixed dogs to attend daycare or board at Blue Dog Ranch if the dogs are 6 months or under. We apologize for any inconvenience.
- Yes
- No
On Some Sort of Flea Preventative?*
Dogs must be current on some sort of flea preventative (for example, frontline or advantage applied every four weeks) in order to attend Blue Dog Ranch. We rely on you to keep this up in order to protect all our dogs. Again, we apologize for any inconvenience, but even if your dog normally does not contract fleas at home, in an environment where groups of dogs are together the risk is much greater, and this is the best way we've found to protect our dogs. We encourage the use of non-toxic, holistic flea sprays.
- Yes
- No
Your home address*
Street AddressAddress Line 2CityState / Province / RegionZIP / Postal CodeCountry
Home Phone Number*
Work Phone Number*
Cell Phone Number*
The above cell phone number is for*
Cell Phone Number
The above cell phone number is for*
Email*
The above email is for*
Email
The above email is for*
Emergency Contact Name*
Emergency Contact Address
Street AddressAddress Line 2CityState / Province / RegionZIP / Postal CodeCountry
Emergency Contact Work Phone Number
Emergency Contact Home Phone Number
Emergency Contact Cell Phone Number*
Emergency Contact Email*
Veterinarian*
Veterinarian Address*
Street AddressAddress Line 2CityState / Province / RegionZIP / Postal CodeCountry
Veterinarian Phone Number*
Veterinarian Email
Are you interested in daycare, boarding or both?*
Will your dog be coming in soon for a boarding stay? If so, when?*
Behavior and Socialization
Is your dog nervous around new people?*
- Yes
- No
Is your dog nervous around new dogs?*
- Yes
- No
Is your dog nervous in new situations?*
- Yes
- No
Is your dog nervous around large groups of dogs?*
- Yes
- No
How long has your dog been living with you?*
Where/how did your dog start living with you? (Please provide any relevant background information, such as history of abuse or lack of socialization before entering into your care)*
Describe dog's normal socialization with people and with dogs (eg. Goes to dog park once a week; Always alone at home; etc.). If they go to the dogpark, please tell us how they act at the dogpark*
Has your dog ever been to a daycare or boarding facility of any kind before? (if so, describe, including whether the facility/ies was/were cage free)*
Has your dog ever been around a group of more than 2 dogs? If so, approximately how many and what was/were the situation(s)?*
Please check any of the following that apply to your dog*
- Very high energy (extremely active)
- Mid-level energy (moderately active)
- Puppy energy (spurts of extremelyhigh energy followed by long naps)
- Low energy (likes to lounge a lot)
Please check any of the following that apply to your dog*
- Loves dogs
- Likes dogs
- Doesn't care about other dogs
Your dog's favorite activity/ies*
Has your dog ever bitten a person?*
- Yes
- No
Please describe the situation(s) and the severity of the bite(s)*
Has your dog ever bitten a dog?*
- Yes
- No
Please describe the situation(s) and the severity of the bite(s)*
Behavioral issues your dog has had in the past (including any incidents of growling at or fighting with any dog or person), when those issues occurred, and what has been done to remedy them*
Behavioral issues your dog is experiencing presently*
Does your dog get along with small dogs?*
- Yes
- No
Does your dog get along with large dogs?*
- Yes
- No
Is your dog particularly scared of any type of human, dog, or event (eg: tall men, balloons, etc.) and how scared is your dog of each of these things (does he or she walk away, bark, shake and hide, etc.)? Please particularly make sure to tell us if your dog is scared of thunder or fireworks and his or her reaction to them, since these are things that do definitely occur every year.*
Dog's favorite toys (eg: plush squeaky; bones, ropes)*
Dog's favorite place to be petted (eg: loves neck, bottom or tummy scratched)*
In order to help us get to know your dog better, please tell us: What are your favorite things about your dog?*
Medical
Dog's Important Medical Conditions (any chronic allergies or other medical problems of which we should be aware)*
Please list all medications (allopathic or homeopathic) which your dog is currently taking, and what your dog is taking them for*
Are there any places your dog does not like to be touched, during grooming or otherwise?*
Please list each (if any) lump, bump, scar, hotspot, cut your dog has on his or her body
Type of mark or lump Exact place on body
Training
Commands your dog understands (sit, stay, down, off or no jump, come, etc.?)*
Types of training, formal or informal, your dog has experienced*
Feeding
Dog's regular food brand or type*
Dog's regular amount at each feeding*
Dog's regular time and frequency of feedings*
Do you give your dog treats?*
- Yes
- No
Please specify dog's treats brands or types*
Please specify dog's treats amounts*
Please specify dog's treats time and frequency of feedings*
Does dog have any allergies, either to any foods or to any other substances?*
If dog has a sibling attending Blue Dog Ranch simultaneously, can dogs be fed together?*
Does your dog eat easily/quickly?*
Does your dog eat with an elevated bowl (as opposed to a bowl on the floor)?*
- Yes
- No
Often, dogs who are in a new place away from home are reluctant to eat. Can we add some of our wet dog food to entice your dog to eat? We usually use something from our store, like the Prairie Nature's Variety Canned.*
If you would prefer we not add our canned food to your dog's food, is there anything we may add (cheese, for example)?*
Does your dog have a strong or weak stomach (can he or she vary his or her diet easily, or does he or she get diahrea or vomit easily when fed a food or treat he or she doesn't usually eat)?*
Sleeping
Where does dog usually sleep (in bed with you, on doggie bed near your bed, in another room, etc.)? Is your dog allowed to get on the bed (ie, can he or she do so here at Blue Dog Ranch?)*
Describe dog's sleeping schedule (time usually goes to bed, awakes)*
Expectations
What are the main reasons you are bringing your dog to Blue Dog Ranch, and what do you hope your dog will get out of the experience?*
Referrals
Where did you hear about Blue Dog Ranch?*
- Google
- Citysearch
- Friend
- Other online/internet source
- Drove by
- Yelp
- Yahoo
- Other
Please specify*
Waiver
Blue Dog Ranch Client Release

I understand that, despite Blue Dog Ranch Inc. (Blue Dog Ranch)'s efforts to maintain the safety of every dog and human at Blue Dog Ranch, there are certain risks involved in doggie day care and boarding. These risks include but are not limited to injuries such as bites or scratches to my dog or me, getting knocked down, my dog getting injured during play or an altercation with another dog and my dog contracting fleas, kennel cough or some other parasite or illness, my dog dying from some illness it already has or some other illness; and that injuries and illnesses can happen in Blue Dog Ranch's play area, lobby, parking lot, or anywhere else in or around Blue Dog Ranch. I voluntarily accept these risks, and release Blue Dog Ranch and its owners, directors, officers, employees, independent contractors and assigns from any and all claims for or arising out of injury or damage of any kind or nature, to me, anyone with me and to my dog in any way related to or resulting from my use of Blue Dog Ranch services or my association with Blue Dog Ranch. This acceptance of risk and release includes but is not limited to claims of injuries or loss to my dog, myself, anyone who picks up or drops off my dog, or to any property that belongs to me. If my dog becomes injured or ill while at Blue Dog Ranch I accept responsibility for veterinary bills and all other costs incurred for care or otherwise due to the injury or illness. I agree that Blue Dog Ranch may use my credit card number, provided in my Blue Dog Ranch Application ("Card"), to pay for all such veterinary and other costs. I understand and agree that this release applies to future unknown or unsuspected claims, and hereby waive Section 1542 of the California Civil Code and any similar law. Section 1542 reads as follows:

"A GENERAL RELEASE DOES NOT EXTEND TO CLAIMS WHICH THE CREDITOR DOES NOT KNOW OR SUSPECT TO EXIST IN HIS OR HER FAVOR AT THE TIME OF EXECUTING THE RELEASE, WHICH IF KNOWN BY HIM OR HER MUST HAVE MATERIALLY AFFECTED HIS OR HER SETTLEMENT WITH THE DEBTOR."

I consent to Blue Dog Ranch obtaining medical attention for my dog from any qualified veterinarian and transporting my dog to and from that veterinarian when Blue Dog Ranch deems such medical care may benefit my dog's health. I grant Blue Dog Ranch or its employees or agents full power of decision involving the medical treatment of my dog, and authorize the use of my Card for such purpose. This release also applies to any claims for injuries or damages related to such medical care or transport.

I consent to Blue Dog Ranch taking my dog for one or more walks when Blue Dog Ranch deems such walks are important for my dog's health. This release also applies to any claims for injuries or damages related to such walks.

If I choose to sign my dog up for a field trip, I agree that this release also applies to any claims or injuries or damages related to such field trips.

If I choose to sign my dog up for the Blue Dog Ranch shuttle service, I agree that this release also applies to any claims or injuries or damages related to such shuttle service.

This release grants consent but does not impose any obligation on Blue Dog Ranch to take any particular action, whether described in this release or not.

I agree to be responsible for all damage my dog causes to property of Blue Dog Ranch, and/or dogs and/or property of others while at Blue Dog Ranch or being transported to or from Blue Dog Ranch or being walked or played with outside of Blue Dog Ranch. I authorize Blue Dog Ranch to use my Card to pay for that damage.

I represent and warrant that my dog is in good health and has not had any communicable illness of any kind for one week prior to attending Blue Dog Ranch. I further represent that each time I bring my dog to Blue Dog Ranch, by doing so I am again representing that my dog is in good health and has not had any communicable illness of any kind for one week prior to such attendance.

I represent and warrant that my dog is currently protected by a flea care preventative (holistic or non-holistic) and that my dog will be protected by this preventative throughout each and every day my dog attends Blue Dog Ranch, each time I bring my dog to Blue Dog Ranch. This representation is for the benefit not only of Blue Dog Ranch but also the other dogs at Blue Dog Ranch and their owners.

I represent and warrant that my dog does not have a history of aggressive behavior towards other dogs or humans.

I represent and warrant that I am at least eighteen (18) years of age and that I have the full, complete and unrestricted right and authority to enter into this release.
I have read and agree to the Blue Dog Ranch Client Release section above.*
- Yes
I understand that I need to bring a credit card to Blue Dog Ranch to put on file to complete the application process.*
- Yes

Blue Dog Ranch

(818) 729-0550

Basic Info

Behavior and Socialization

Medical

Training

Feeding

Sleeping

Expectations

Referrals

Waiver

Blue Dog Ranch Client Release

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