Welcome to Barkaritaville Pet Resort! 
New Guest Information
Please tell us how you heard about us:
___________________________________

Pet Information
1st  Pet:

2nd Pet:
3rd Pet:
Breed:

Breed:
Breed:
Color:

Color:
Color:
Birth Date:                     Weight:

Birth Date:                     Weight:
Birth Date:                    Weight:
Male                     Neutered?   Yes / No
Female                  Spayed?     Yes / No
Male                      Neutered?   Yes / No
Female                  Spayed?     Yes / No   
                     
Male                      Neutered?   Yes / No
Female                  Spayed?     Yes / No      
                          
Vaccination Current?  Note: We require proof of these vaccinations from your veterinarian prior to stay.
Rabies     __________  Parvo/Distemper      __________
Bordatella (Canine Cough)     __________       
Annual Fecal     __________	
(Cats Only) RCPC/Felv       __________
Veterinary Hospital:


Veterinarian’s Name:

Phone:

About your Pets Health:
Is your Pet(s) on Flea & Tick Medication?

Brand Name and date last applied:

Does your pet(s) have any medical condition(s)?

Pet name, Condition & Medication:
Has your pet(s) ever bitten anyone? If yes, Why?
Is your pet(s) micro chipped or tattooed?                                      Identification #


Owner Information
Name:

Home Phone:
Address:

Cell Phone:
City:

Work Phone:
State, Zip

Email Address:
Emergency Contact:

Emergency Phone:
I have read and understand the Boarding Policies and Requirements of Barkaritaville Pet Resort and agree with its terms and conditions. I certify that my pet(s) will be current on all required vaccinations at the time of boarding and I will supply Barkaritaville Pet Resort with the appropriate documents and phone number of the veterinarian who administered these vaccinations. I also authorize Barkaritaville Pet Resort to do whatever it deems necessary for the health and well being of my pet(s) during their stay and agree to pay for any and all expenses relating to same.
Pet Owner’s Signature:_______________________________________________	Date:___________________