Day Camp Application

Pet Owner's Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Primary Telephone *

Secondary Telephone *

E-mail *

Dog's Name *

Sex *

Male
Female
Neutered Male
Spayed Female

Color & Markings *

Veterinary Clinic & Phone *

Age and/or DOB *

Microchip/Tattoo Number *

Current Cumberland County PA License number *

Does your dog have any known medical conditions? If so, please list. *

Does your dog have any known food allergies? If so, please list. *

I hereby agree to the foregoing as the owner of the aforementioned pet.

My dog has dug holes in the past: *

Yes
No

My dog has climbed or jumped fences ever in the past: *

Yes
No

My dog chews up bedding or toys: *

Yes
No

What type of veterinary purchased flea and tick preventative do you use for your dog? (Receipt required if not purchased at HPVC) *

What type of veterinary purchased heartworm and intestinal worm preventative do you use for your dog? (Receipt required if not purchased at HPVC) *

Is your dog afraid of other animals (if so, tell us more)? *

Has your dog ever growled at a person or a dog? *

Yes
No

If yes, tell us about the situation *

Has your dog ever bitten a person or animal? *

Yes
No

If yes, tell us about the situation *

Infectious Disease Requirements

Our infectious disease risk reduction policy requires the following: Year-round use of veterinary flea & tick prevention (receipt required) • Year-round use of veterinary heartworm & intestinal worm prevention (receipt required) • Current vaccination requirements: Rabies, Distemper/Parvo, Kennel Cough, and Bivalent Influenza (veterinarian vaccination only) • Permanent identification (microchip or tattoo) • Negative fecal testing every 6 months • Current Cumberland Co. PA dog license - (license tag must be on their collar or harness that they wear to day camp) **If your pet is experiencing sneezing, coughing, eye discharge, vomiting, diarrhea, fever, or communicable skin infection they MUST stay home until a veterinarian has provided documentation declaring them non-infectious** *

Yes, I understand

Late Pick-Up/Extra Care Policy

Healing Paws Day Camp closes promptly at 5:00 pm each evening - day campers may be picked up between the hours of 4:30 pm and 5:45 pm and must announce their arrival by messaging according to parking lot signage. All pets must exit the building by 5:45 pm. The day camp’s wifi clock will serve as the “official clock” for determining time. Please synchronize your watch with a wifi based time clock. A No Exception Discharge Time Policy is in place for several reasons. Most pets’ internal body clock knows when their usual pick-up time is! Pets can become nervous, fearful, or hungry when they are at camp later than normal. Please know that your pet will always be comforted and safe, even in the event of an emergency - our staff will not leave them alone. Our day camp staff give their best to your pets each day and they also have responsibilities to their own children, pets, and family. They have extensive sanitation procedures to perform after your pets go home and they need to know that they can end their work shift reliably daily. Late pick-ups require staffers to postpone cleaning procedures and delays their day’s end time in order to avoid rushing important sanitation procedures. As of May 1, 2021, our late policy is as follows: A fee of $1 for every minute that your pet is in the building after 5:45 pm is applied per pet. Pets must be picked up by 6:15 pm WITHOUT EXCEPTION. This invoice will be messaged to you upon arrival and must be paid at the time when you pick up your pet. There will be no exceptions or warnings. If you are late for ANY reason, a charge will be issued. This No Exception• policy makes it easier for us to apply the late policy to everyone consistently and fairly. It will be greatly appreciated, however, if pet parents call to notify us if they will be late and give an approximate arrival time so that we can better plan to keep your pet comfortable. *

Yes, I understand

Behavioral Assessment:

To be eligible for day camp at Healing Pas Veterinary Care, Inc. (“Healing Paws”), your dog must first pass a day long behavioral assessment. This professionally developed assessment is completed by senior level team members and determines if your pet enjoys and benefits from group play and structured rest time. If your pet shows signs of anxiety that cannot be overcome or does not interact well with appropriate play groups or staff members, they may not pass the day camp assessment. This behavioral assessment is focused on group play. Daycare is only available to dogs who do well in group play environments and settle comfortably during downtimes.

Personal Items:

We make every effort possible to make your pet feel at ease while they are staying with us. Healing Paws does not recommend bringing personal items from home as they may get lost or soiled. We also do not accept fabric or plush items to avoid pest contamination. Food items must be in a labeled plastic container that can be sanitized easily. Healing Paws is not responsible for lost or damaged personal items.

Abandonment:

If the pet is not called for within 10 days after the designated checkout time, the pet will be considered abandoned and will be handled in accordance with state law. All adoption fees and other incurred expenses will be the responsibility of the owner.

Playgroup Risk:

Playgroups are monitored by Pet Care Specialist team members and are paired based on behavioral assessment, size, age and play style. While Pet Care Specialists keep a close eye on playgroups and are equipped to break up pets as needed, there is still a risk of injury to those pets participating in playgroups. If injury occurs, your Healing Paws medical team will examine your pet and provide treatment necessary to make your pet comfortable. The owner gives permission to Healing Paws and its doctors and medical staff, in its discretion, to give first aid, medication, or other attention when deemed necessary for the health, and safety of your pet. Healing Paws is authorized by the owner to provide veterinary care, including emergency care, at the owner's expense. If we believe that your pet is in need of care, time permitting we will attempt to contact you before providing that care, but this document serves as our authorization to provide veterinary care for your pet in the event we are unable to reach the owner before treatment must be started. By signing below, you certify the accuracy of all information given about your pet and that you have disclosed and discussed any previous signs of aggression or threatening behavior toward any person or animal.

Treatment Authorization:

You, as the pet owner, hereby agree that Healing Paws Veterinary Care, Inc. (“Healing Paws”), may, in its sole discretion, give first aid, medication, or other attention it deems necessary for the health and safety of your pet, or other pets under its care or in its facilities. You authorize Healing Paws to provide veterinary care, including, but not limited to, emergency care, at your expense. If Healing Paws’ personnel believe that your pet is in need of care, time permitting, we will attempt to contact you before providing that care, but this document serves as our authorization to provide veterinary care for your pet in the event we are unable to reach you. If fleas or evidence of fleas are found on your pet, you agree to allow Healing Paws’ personnel to treat for fleas at your expense. You are responsible for all expenses of veterinary care, including, but not limited to, services, medications, and supplies, whether or not you have been reached in advance. Your signature on this authorization permits Healing Paws to make reasonable care decisions regarding your pet; and the owner agrees to pay for all costs incurred for such treatment.

General Terms:

Healing Paws will exercise responsible care for the safety of your pet, and to keep the boarding premises safe and properly enclosed. Pets will be fed and watered regularly, and housed in clean, safe quarters. Healing Paws cannot guarantee against accidents, and we cannot be liable for loss or damage caused by or to our pet guests at this facility. You agree to be solely responsible for any and all damage to equipment, property, or other pets caused by your pet while it is at this resort. In the unlikely event that a pet passes away while a guest of Healing Paws we will contact you and discuss your options of body care with you. You hereby and forever waive any and all claims arising in any way out of your pet’s stay at Healing Paws, and further agree to indemnify forever Healing Paws, its officers, directors, employees, shareholders, agents, successors, and assigns from and against any and all loss, damage, claim, or cause of action, whatsoever.

Payment:

Payment balance for day camp services is due upon discharge of your pet. We accept cash, checks drawn from a local bank, debit cards, VISA, and MasterCard. We charge a $50 fee for returned checks. Furthermore, in the event you refuse or otherwise fail to make payment owed for services rendered by us in caring for your pet, you are responsible for any and all costs of collection incurred by us, including attorney’s fees and court costs, to collect payment(s) from you.

Acknowledgment of Agreement: I represent that any information I provided above is accurate and that I have read, fully understand, and agree to the terms set forth herein. I have been informed that estimates for recommended services/procedures are available upon request. I further understand that all services performed on my pet will be invoiced according to Healing Paws’ procedures. *

I have read and understand.

Digital Signature *

Today's Date *

Please note: We will be closed on July 5th, 2021 in observance of Independence Day!