Owner's Name:
Dog's Name: Breed: Color:
Address: City: State: STATE AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA MA MD ME MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY ZIP:
Home Phone: Cell Phone:
E-Mail:
Vet Clinic: Vet Phone:
Emergency Contact Emergency Phone:
Has your dog shown signs of aggression towards other dogs? Dogs Yes No
Has your dog shown signs of aggression towards people? People Yes No
Any physical limitations or medical conditions? If yes, please provide details:

Any special care instructions?

How Did You Hear About Us? Yellow Pages Yahoo Google MSN Friend FaceBook.com Yelp.com Vet referred Dog park Other If Other, Please Specify:
I have read and agree to the terms of the Doggie Hotel and Daycare Contract Contract Yes No
I have read and agree to the terms of the Doggie Hotel and Daycare "Good Dog Rules: Rules Yes No

We will ask you to sign the submitted hard copy form when you come for the "meet & greet." Please remember to bring proof of vaccinations at this time.
Health & Safety come first at Benny's Dog Resort, every dog is evaluated and carefully screened before being accepted into our programs in order to ensure a safe environment for all of our canine friends. Your dog must be: 6 months or older, Spayed or neutered, Non-aggressive and able to play well with other dogs and people, Not excessively loud (example: constant barking), I like to keep my hearing. Healthy and up-to-date on all shots (Rabies, DHLPP + Bordetella - This vaccination is required). Your vet can fax the records to fax: 866-638-5244 Any questions? Please call us at (972) 466-3653 or send us e-mail at bennysdogresort@yahoo.com