All dogs over 6 months old must be spayed or neutered prior to attending our facility. Please take the time to fill out this form completely. Should you need applications for additional dogs, after submitting this form, simply fill out another form, but feel free to omit the personal information area (except for your First and Last name). Please feel free to email pictures of your pet! Mail all images of your pet, along with your First + Last name to contact@swansonstreamway.com Swanson's Streamway Dog Park and Daycare is a non-smoking facility, located on a non-smoking premises. 1st Dog's Information: Dog's Name: Sex:  Choose One... Neutered Male Spayed Female Male (Intact) under 6 months old Female (Intact) under 6 months old (All dogs over 6 months old MUST be spayed or neutered) Breed:   Color:   Markings:  Age: years months Distinguishing physical characteristics:  Temperament issues (shyness, fear, etc):  Describe any medical or physical problems:  Does this dog have any allergies? if so, to what:  Is this dog used to being in a crate? Yes No Not Sure Does this dog have separation anxiety issues? Yes No Not Sure Has this dog ever escaped from a fence (over or under)? Yes No Not Sure Does this dog get along well with other dogs? Yes No Not Sure Does this dog get along well with puppies? Yes No Not Sure Has this dog ever attended interactive Daycare? Yes No Not Sure     Any additional information to help us care for your dog:  We feed Science Diet brand dog foods at our facility. Sudden diet changes can cause upset stomachs and loose stools. For this reason, we would like to encourage everyone to bring rations of their dog's own food if they do not eat Science Diet regularly.   2nd Dog's Information: Dog's Name: Sex:  Choose One... Neutered Male Spayed Female Male (Intact) under 6 months old Female (Intact) under 6 months old Breed:   Color:   Markings:  Age: years months Distinguishing physical characteristics:  Temperament issues (shyness, fear, etc):  Describe any medical or physical problems:  Does this dog have any allergies? if so, to what:  Is this dog used to being in a crate? Yes No Not Sure Does this dog have separation anxiety issues? Yes No Not Sure Has this dog ever escaped from a fence (over or under)? Yes No Not Sure Does this dog get along well with other dogs? Yes No Not Sure Does this dog get along well with puppies? Yes No Not Sure Has this dog ever attended interactive Daycare? Yes No Not Sure     Any additional information to help us care for your dog:  We feed Science Diet brand dog foods at our facility. Sudden diet changes can cause upset stomachs and loose stools. For this reason, we would like to encourage everyone to bring rations of their dog's own food if they do not eat Science Diet regularly. Personal Information: First Name: Last Name: Street Address: City: State: ZIP: Home Phone #: Work Phone #: Ext. Cell Phone #: Email Address Emergency Contact Information: Please tell us who to contact in the case of an emergency: 1) Name: Phone #: 2) Name: Phone #: If anyone other than the owner listed above has permission to pick up or drop off your dog, please list their full names: Veterinary Information: Name of Veterinarian: Name of Clinic: Clinic Phone #: Vaccination Policy: All dogs presented to our facility must be current on the following vaccinations: Rabies - every 12 months Distemper-Parvo Combo - every 12 months Bordetella (Kennel Cough) - every 6 months We will need proof from your veterinarian that the vaccinations for your dog(s) are current prior to their boarding/daycare stay. Your vet may fax proof of vaccinations and their expiration dates to our office at 913-825-6138. Please keep in mind that we require the Bordetella (kennel cough) vaccine to be updated every six months and the distemper/parvo and rabies yearly. Please note: the Bordetella vaccine requires a two week incubation period for the injection, or 48 hours incubation for the intranasal. These vaccinations are very important for the health of your dog and other dogs who visit our facility. According to our policy, if the vaccinations are not current at the time of drop off we will not be able to accept your stay. IMPORTANT: Read before pressing "Submit" As a condition of using our services for your pets, and by pressing the "Submit" button, you agree to the following Waiver & Assumption to Hold Harmless. By choosing to utilize the services, participate in activities, groom or enroll my pet(s) at Swanson's Streamway Dog Park and Daycare Inc., I agree to the following: I agree to pay the rates that are in effect at the time my pet is at Swanson's Streamway Dog Park and Daycare. I am aware that extra charges may be incurred and I agree to pay them at the time of pick-up. Examples include, but are not limited to: Daycare, Grooming, and Training. I understand that on entering Swanson's Streamway Dog Park and Daycare my pet(s) will be examined for fleas. If fleas are found, flea treatment will be administered at my expense. If my dog participates in playgroup or daycare, I understand that an interactive play setting is not without some risk of injury, that despite all the dogs appearing healthy and being handled with the greatest amount of care and foresight, dogs are not always predictable and the unexpected may occur. I recognize that the benefits of an interactive playgroup are valuable to my dog, and accept the potential risks. I further agree to pay veterinary/medical expenses incurred as a result of injury to or caused by my dog. If my pet appears to be ill, I authorize Swanson's Streamway Dog Park and Daycare to engage the services of a veterinarian at my expense, to give other requisite attention, and to make whatever decisions are required for my pet's veterinary treatment. I agree to pay all veterinary charges incurred by my pet while in the care of Swanson's Streamway Dog Park and Daycare. I will not hold Swanson's Streamway Dog Park and Daycare liable for failure to seek veterinary attention or for decisions made under this contract. I understand that Swanson's Streamway Dog Park and Daycare will exercise all due diligence and care in the guardianship of my pet. I hereby waive and release Swanson's Streamway Dog Park and Daycare Inc., its employees, owners and agents from any and all liability of any nature, for injury or damage, including that which may result from the action of any dog including my own, and I expressly assume the risk of such damage or injury while my dog participates in or attends any function of Swanson's Streamway Dog Park and Daycare, while on the grounds or the surrounding area thereto. I understand that "off-leash" areas are used at my own risk.  While the designated areas are fenced in, no fence is airtight. Swanson's Streamway Dog Park and Daycare is not responsible for any dog that is able to escape from "off-leash" areas. On behalf of myself and any and all other owners of this/these pet(s), I have read and agree to the terms of this contract. I warrant that I have the authority to represent any and all other owners of this pet in agreeing to these terms by pressing the "Submit" button.