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Board + Train Registration
1
About You
2
About Your Dog
3
Medical
About You
Please provide information for the legal guardian of the dog. Please only fill out form if you are legally responsible for the dog.
First Name
*
Last Name
*
Address
*
Suite | Unit Number
City
*
State | Province
*
Select State or Province
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Saskatchewan
Quebec
Yukon
ZIP
*
Phone
*
eMail
*
Emergency Contact
Please provide the name and phone number of a person we can contact in the event of an emergency with your dog. A person living in the Coachella Valley is preferred but not mandatory.
Contact Name
*
First
Last
Phone
About Your Dog(s)
Type of Training
*
Socialization/House Behavior
Housebreaking
On Leash Obedience
Off Leash Obedience
Destructive Behavior
All of the Above
Dog's Name
Dog's Gender
*
Female
Male
Is she spayed?
*
Yes
No
Approximately when was she spayed?
*
MM slash DD slash YYYY
Is he neutered?
*
Yes
No
Approximately when was he neutered?
*
MM slash DD slash YYYY
Dog's Breed
*
Dog's Age
Select Age
Under 4 Months
5-6 Months
7-9 Months
10-12 Months
1 Year
2 Years
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
11 Years
12 Years
13 Years
14 Years
15 Years+
Is your dog up to date on its Rabies vaccination?
*
Yes
No
Date of vaccination
*
MM slash DD slash YYYY
Is your dog up to date on its Parvo vaccination?
*
Yes
No
Date of vaccination
*
MM slash DD slash YYYY
Is your dog up to date on its Bordetella vaccination?
*
Yes
No
Date of vaccination
*
MM slash DD slash YYYY
Is your dog up to date on its Distemper vaccination?
*
Yes
No
Date of vaccination
*
MM slash DD slash YYYY
Does your dog have any allergies?
Yes
No
Describe allergies
*
Does your dog have any current medical conditions?
Yes
No
Describe conditions
*
Is your dog currently taking any medications?
Yes
No
List medications
*
Is your dog under the care of a vet?
Yes
No
Vet Clinic Name
*
Veterinarian's Name
*
Phone
*
Authorization
I give Valerie Masi DBA Best Paw Forward full authorization to take my pet
*
To Dog Park
To Friend's House
To Public Stores/Street Fairs
On Public Walks
To Socialization/Obedience Classes
To Private Obedience Classes
Medical Consent
Medical Costs
*
I Understand and Agree
I understand and am aware that my dog may eat other dog’s food or show destructive behavior and as a result get ill. I take full responsibility for all medical cost due to my dog’s behavior.
Medical Care Authorization
*
I Authorize
I hereby authorize Valerie Masi DBA Best Paw Forward to take my pet for Veterinarian care in the event of an accident or illness while in the care of Best Paw Forward. I authorize medical care up to the amount listed below. I also promise to reimburse Valerie Masi DBA Best Paw Forward for any medical fees that were paid up front for pets' care.
Authorized Amount
*
Release Of Liability
Discharge of Liability
*
I hereby forever release and discharge Best Paw Forward, Valerie Masi, employees or any person acting on its behalf, Other boarding dog owners from any claims, liability, action for damages, compensation or otherwise known, on account of or arising out of Boarding or Boarding training and/ or your pets or Kennel dogs behavior. I take full liability for my pet’s behavior at all times during training and thereafter.
I Understand & Agree
Free Roam
*
I am aware and understand that my dog will not be confined to a kennel and will be roaming free with other pets. I understand that dogs will not necessarily get along with all other dogs or cats, I am aware that a fight or a scuffle may happen. I will take full responsibility for my dogs medical care as a result from the above mentioned.
I Understand & Agree
Dog in Public
*
I understand that while training my dog, Valerie Masi DBA Best Paw Forward will be taking my dog outside Best Paw Forward facility. I understand and am aware that while my dog is out in a public venue or on the streets that my dog could be harmed by a free roaming animal or any other unforseen event. I understand there is a risk of my dog getting loose. I accept all responsibility for my dog’s actions and any harm that may come to my dog. I Indemnify, Hold Harmless, and Promise Not To Sue Valerie Masi, Best Paw Forward employees or any person acting on its behalf, any business Valerie Masi may be taking my dog too or private individual.
I Understand & Agree
Name
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Contact:
Call Us: (760) 885-9450 Or eMail Us Any Time:
Name
*
eMail
*
Phone #
*
Message
*
Phone
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