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Holly Ridge Manor Canine Country Club
Holly Ridge Manor Pet Activity Center
IMPORTANT NOTE:
***All dogs must be up to date on Rabies, Bordetella (kennel cough) & Distemper***
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Indicates required field
Name
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First
Last
Dog's Name
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First
Last
Breed
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Color
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Sex
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Male
Female
Spayed/Neutered?
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Yes
No
Phone # (Home)
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Phone # (Cell)
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Phone # (Work)
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Address
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Line 1
Line 2
City
State
Zip Code
Country
Email
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Emergency Contacts
Contact #1
Name
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First
Last
Phone # (Home)
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Phone # (Cell)
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Phone # (Work)
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Contact #2
Name
*
First
Last
Phone # (Home)
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Phone # (Cell)
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Phone # (Work)
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Veterinarian Contact
Vet's Name
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Phone Number
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Health Conditions
Does your dog currently suffer from any of the following conditions:
Seizures?
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Yes
No
If yes, please describe & list medication (if applicable)
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Skin Problems?
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Yes
No
If yes, please describe & list medication (if applicable)
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Hip Displasia?
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Yes
No
If yes, please describe & list medication (if applicable)
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Prior Injuries?
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Yes
No
If yes, please describe & list medication (if applicable)
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Heart Problems?
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Yes
No
If yes, please describe & list medication (if applicable)
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Liver Problems?
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Yes
No
If yes, please describe & list medication (if applicable)
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Anxiety/Nervous Condition?
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Yes
No
If yes, please describe & list medication (if applicable)
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Allergies?
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Yes
No
If yes, please describe & list medication (if applicable)
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Please list any other medical problems (not listed) that we should be aware of:
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Personality Profile
Does your dog have separation anxiety?
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Yes
No
If yes, please describe & list medication (if applicable)
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Is your dog a rescue?
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Yes
No
Any known abuse?
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Yes
No
If yes, please describe
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Is your dog food or toy aggressive?
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Yes
No
If yes, please describe
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Is your dog scared of thunderstorms?
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Yes
No
If yes, please describe & list medication (if applicable)
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Does your dog have issues with certain breeds of dogs?
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Yes
No
If yes, please describe
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Is your dog submissive or dominant with other dogs?
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Yes
No
Submissive: Rolling over or cowering Dominant: Stands tall, hair goes up on back, you feel a little unsure when meeting new dogs
If yes, please describe
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Will your dog jump or climb fences?
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Yes
No
If yes, please describe what kind and how high
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Is your dog crate trained?
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Yes
No
Has your dog ever showed signs of being unpredictable?
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Yes
No
If yes, please describe
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****************IMPORTANT****************
It is very important you answer this section truthfully for the safety of our staff
Has your dog ever bitten anyone?
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Yes
No
If yes, please describe
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Was a report to animal control taken?
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Yes
No
If yes, what agency?
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Date report was taken (MM/DD/YYYY)
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**********You must alert management immediately if your dog bites someone**********
Why are you considering doggie daycare?
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How many days a week would you like to enroll your dog?
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1
2
3
4
5
What days are you interested in?
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Mon.
Tues.
Wed.
Thurs.
Fri.
Please carefully read all of the following statements and check "Yes" to acknowledge they've been read:
**** All statements MUST be checked in order to submit this form****
While at daycare my dog will run, play, swim, dig, and rough play. All of which could result in injury. Understanding the risks involved, I will allow my dog to socialize.
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Yes
While playing with other dogs, accidents can occur.
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Yes
If your dog is injured, we will call you first. If we can’t reach you, we will then call the emergency contact you have listed. If we can’t reach anyone, we will seek medical treatment immediately.
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Yes
If your dog exhibits and bad behavior while in daycare, we will send a letter home. If the behavior continues and can’t be resolved, we will be forced to expel him/her from daycare.
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Yes
If your dog is ill, or exhibits any symptoms of being sick, we will call you immediately to come pick him/her up.
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Yes
We will not allow dogs into daycare with medical conditions such as ear infections, diarrhea, has stitches or is limping. We believe that if your dog is in pain or not feeling well, he/she needs to be at home where he/she can be more comfortable.
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Yes
The daycare is open from 7am to 7 pm. We have a lot of preparation work to do before 7 am and we do not open early unless prior arrangements have been made.
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Yes
You will be charged an additional $5 late fee for all dogs picked up between 7:00 pm and 7:15 pm. If you pick up your dog between 7:15 pm and 7:30 pm you will be charged an additional $10 late fee. After 7:30 pm you will not be allowed to pick up your dog. Your dog will be taken to the motel to sleep overnight. You will be charged $35 and it will be due the following day. To avoid charges for another day you must pick up before NOON.
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Yes
All payments are due at the time services are rendered. Failure to pay will result in dismissal.
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Yes
There is a 30 day trial period. If, after 30 days your dog has not adjusted to the daycare you will be notified.
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Yes
The daycare will close in extreme weather. Please call our office at 757-721-7829 or check Facebook for all closings or delays.
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Yes
Reservations are preferred but not required. Please call ahead to make sure we have availability. Walk- ins are welcome but will only be admitted if space is available.
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Yes
If I need to make boarding arrangements, I must call the motel at 426-6100. During certain holidays, the daycare can take overnight stays but special arrangements for this must be made well in advance.
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Yes
If I want my dog to have a bath or a special spa treatment, I must make the appointment at the time of drop off and give the staff a time of pick up. Appointments for our Pet Stylist or for nail trims must be made at the motel by calling 757-426-6100.
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Yes
Auto billing is available. Visa and Master cards are the only credit cards we accept.
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Yes
There is a $25 check fee if a check is returned due to insufficient funds.
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Yes
If my dog is injured, I, the owner, will be responsible for all medical cost.
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Yes
I will submit updated vaccine documents yearly.
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Yes
I will keep my dog on flea and tick prevention while in daycare.
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Yes
Reimbursement or credit to my account must be made by management.
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Yes
You can bring lunch in for your dog daily =)
VET RELEASE FORM
Although the staff at Holly Ridge Manor closely monitors your pet, sometimes active play and roughhousing pose the possibility of injury. Additionally, certain illnesses and infections can be transmitted during boarding. Animals identified as being infectious will be isolated to the extent possible. Common injuries associated with boarding include, but are not limited to, bruises, lameness, abrasions, punctures, intestinal ailments (vomiting or diarrhea), coughing and skin irritations. These problems usually resolve with appropriate treatment.
If your pet develops any health problems, HRM will pursue treatment with one of the following: your veterinarian, Princess Anne Veterinary Hospital, or an emergency treatment facility. Treatment may include, but is not limited to, injections, medication, and diagnostic testing. HRM will pay for the treatment when veterinary services are rendered, but the owner/responsible party is responsible for reimbursement at time of pick up.
The staff at HRM will make reasonable effort to contact the owner and/or emergency contacts should medical treatment be needed.
In the event that no contact is reached, please indicate your preference of action:
Choose an option
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Yes, please perform whatever services the doctor deems necessary for the best care of my pet until someone can be reached.
No, do not administer any medical treatment until specific authorization is given.
I, the undersigned, so hereby certify that I am the owner (or duly authorized agent for the owner) of the animal aforementioned and authorize the doctors and staff at Princess Anne Veterinary Hospital or any other veterinary facility full and complete authority to provide medical care to promote the good health of my pet(s).
OWNER/RESPONSIBLE PARTY DIGITAL SIGNATURE
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DATE (MM/DD/YYYY)
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Submit
Home
Doggie Daycare
Pricing
Dogs at Play
Dog Motel
Motel Dogs at Play
Motel Pricing and Common Questions
Rooms
Other Services
Horse Motel
Puppy Playground
Transport
Canine Training
Events
Contact
