Park Cities Obedience School

Registration Form

Your Information:

Emergency Contact Information

Your Dog's Information:

***We only require that you put the dates that the shots expire***
Reason for Visit: *

Dog Profile:

Rate your dog's energy level "1" being very mellow and "10" being a total spaz: *

Liability Waiver/Health & Temperament Agreement

  1. I understand and agree that in admitting my dog, Park Cities Obedience School (hereby known as PCOS) has relied on my representation that my dog is in good health and has not harmed or shown aggression or threatening behavior towards any person or any other dog.
 2.       I understand that when dogs are exposed to each other they are at an increased risk of catching communicable diseases and picking up parasites that are common to canines. You dog may become ill even though he/she has been vaccinated.  Common illnesses/parasites include (but are not limited to) upper respiratory infections, giardia, internal parasites.
  3.      I understand and agree that PCOS and their staff will not be liable for any problems that develop provided reasonable care and precautions are followed, and I hereby release them of any liability of any kind whatsoever arising from my dog’s attendance and participation in activities at PCOS
4.      I understand and agree that any problem that develops with my dog will be treated as deemed best by the staff of PCOS, in their sole discretion, and that I assume full financial responsibility for any and all expenses involved in treatment. 
5.       PCOS reserves the right to refuse admittance to any dog that does not meet the health and temperament requirements.
6.    I understand that dogs at PCOS must spend time outside to relieve themselves.  This may result in the dogs becoming dirty, stained, wet and/or muddy depending on the weather.
7.      I understand that dogs can and will play roughly with each other and will use their teeth and nails during play.  This can result in the dogs’ receiving nicks, cuts, scratches and/or bites. 
8.      I understand that items such as toys, beds, blankets, etc. brought in with dogs may be destroyed by the dogs during play or inadvertently lost
9.       I certify that I have read and understand the rules and regulations of PCOS as set forth in this agreement.  I agree to abide by the rules and regulations and accept all the terms, conditions and statements of this agreement.
Signature of Owner/Agent *

Veterinary Treatment Consent

To whom it may concern: During my absence Park Cities Obedience School (PCOS) will be caring for my pet(s). I give PCOS my permission to transport my pets to my veterinarian (or to an emergency clinic). In the event I cannot be reached, I authorize PCOS to act as an agent on my behalf regarding my pets’ medical care. I authorize veterinary treatment and accept full responsibility for charges incurred in the treatment of my pet(s), not to exceed the following amounts for each pet:

Maximum Amount if any:

(or write N/A if you DO NOT wish to set a maximum you will spend on your dogs care).
I understand that PCOS assumes no responsibility for the loss of any pet and is released from all liability related to transportation, treatment and expense.
I do / do not agree to authorize said veterinarian to euthanize my pet in extreme circumstances under his/her advisement after all reasonable attempts have been made to reach me.
This consent for treatment has no expiration date unless otherwise noted. A photocopy/facsimile of the signed consent shall have the same force and effect as the Client/Pet Owner’s original signature.

This form will be retained on file and will be used to authorize veterinary treatment in the event that your pet(s) require treatment during your absence, while in our care, and we are unable to contact you at the time.

* This form MUST be signed to authorize treatment.

Client Signature Name *

Credit Card Authorization

Owner agrees that this credit card can be used for any and all services performed by Park Cities Obedience School for the dog(s) named above.


By signing this agreement, the Owner agrees that this credit card can be used to pay for dog daycare, boarding, grooming, bathing, training, reimbursement for veterinary bills incurred on behalf of the above mentioned dog(s), including veterinary emergency room bills, bills at the Owner’s veterinarian and bills at the veterinarian used by Park Cities Obedience School, deposits for boarding reservations and no-show and cancellation fees.  Owner also agrees that this credit card can be used for bank fees in the event that a check is returned for any reason.

Powered byFormsite