New Customer

First Name(required)

Last Name(required)

Address(required)

Suburb(required)

Home Phone

Work Phone

Mobile(required)

Email(required)

Emergency Contact Name(required)

Emergency Contact Phone Number(required)

Referred by(required)

Pet's Name(required)

Breed(required)

Colour(required)

Sex(required) Neutered Male

Entire Male

Speyed Female

Entire Female

D.O.B or Age(required)

Veterinary Clinic(required)

Weight(required)

Diet

Medication (if any)

General Comments

Booking Dates From (include date & month)(required)

Booking Dates To (include date & month)(required)

Check out time (NOTE: after 11.00am = extra day charge)(required) 11am 7 days per week

Mon – Fri 3pm to 6pm

Sat – Sun by 4pm

Accommodation Required(required) Hotel Suite (includes two walks a day and all day playing/socialising)

Motel Kennel (includes one walk a day and all day playing/socialising)

Motel Cattery

Extra Pine Forest Walk or Paddock Playtime ($12.50 per day) Every Day

Every Second Day

Other

If OTHER for above, please state below your requirements

Please confirm your dog is social with other dogs & people(required) Yes

No

Not applicable (I'm booking in a cat)

I CONFIRM my dog is not registered as a DANGEROUS DOG or has any other such restrictions.(required)

If you agree to the terms and conditions please tick(required)