Kitty Camper ApplicationYou will only need to fill out this form as a new camper for boarding your kitty. If you have any updates, you can fill out the Short Form to send new information to us. - Step 1 of 12Welcome to The Lodge Luxury Boarding Retreat!We are excited that you considering The Lodge for Daycare and Boarding for your kitty, or as we like to say, your “Camper.” Please complete this application to the best of your knowledge and make sure you read and understand the attached policies, release and waiver.PARENT'S INFORMATIONParent's Name *FirstLastEmailAddress *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeHome PhoneWork PhoneCell Phone *NextCAMPER'S INFORMATIONCamper's Name *Birthdate/AgeWeightlbsBreedColorSexMaleFemaleSpayed/NeuteredYesNo(Required at 8+ months)Veterinarian HospitalVet Phone NumberPreviousNextADDITIONAL PETS LIVING WITH YOUR CAMPERDo you have additional pets living with your camper? If so, how many? *0123Name - Pet 1BreedSexMaleFemaleAgeName - Pet 2BreedSexMaleFemaleAgeName - Pet 3BreedSexMaleFemaleAgePreviousNextVACCINATIONSGuardian/Owner is required to provided veterinary proof of current and updated FVRCPC and RabiesCAMPERS PAST MEDICAL HISTORYDoes your Camper have any of the following? *Heart ConditionThyroid DiseaseAllergiesSeizures*Physical Limitations**Cushing's DiseaseCancerOther***NoneIf yes to any of the above conditions, please explain:Seizures* - Please describe frequency, severity, cause of occurrence, behaviors to look for, etc. Physical Limitations** - Arthritis, Missing Limb, Blind, Deaf, etc. Other*** - Please describePreviousNextEMERGENCY CONTACT (SOMEONE OTHER THAN YOURSELF)Emergency Contact NameRelationshipHome PhoneWork PhoneCell PhonePreviousNextLEARNING MORE ABOUT YOU AND YOUR CAMPER'S NEEDSHow did you first hear about the Lodge?Drive-BySocial MediaNewspaperEventEmailReferralSearch EngineOtherReferral Name (if applicable)OtherHave you ever used day boarding services at another facility?YesNoIf yes, please list the names of such businesses:Have you visited The Lodge Luxury Boarding Retreat/Animal Hospital of Montgomery before?YesNoWhat are the primary reasons for bringing your Camper to camp?Camper loves to playI don't like to leave my Camper alone all dayI travel extensivelyI work long hoursCamper needs a lot of exerciseCamper needs a vacationRecommendation of trainer or other personCamper gets lonelyCamper exhibits destructive behaviorsWhich services are you looking for?DaycareBoardingBathing/Nail ClippingAre there any other services you would like for The Lodge to offer in the future?PreviousNextGETTING TO KNOW YOUR CAMPERDoes your Camper engage in any unusual repetitive behavior?YesNoIf yes, please explainDoes your Camper have any destructive behavior?YesNoIf yes, please explainCheck all that describes your Camper's personality:OutgoingSensitivePushyReservedAggressivePlayfulTalkativeAffectionateChewerSnugglerGrowlerMouthyAfraid of StormsTimidBiterProtectiveHappyAfraid of MenFriendlyFearfulOther personality descriptions:If your Camper has any fears, what soothes him/her?Where is the favorite spot on their body to be pet?What are their favorite treats?What are your Camper's favorite play activities? (Check all that apply)Playing with ToysCap Nip"Tree Climbing"Socializing with PeopleSnugglingPlaying with other catsOther favorite play activities:Is your Camper Microchipped?YesNoCheck all that describes situations where your pet may become unfriendly:Grabbing CollarLoud NoisesPettingTouching PawsRemoving FoodTouching EarsTouching TailTouching While SleepingTaking Away ToysBeing Around Strange DogsBelly RubsBathsOther situations:Check all behaviors (if any) that apply to your Camper that we need to know about:SnapsHissGrowlsBares TeethFreezesHidesRuns AwayBacks AwayMay BiteWill BiteTremblesSwatsOther behaviors:PreviousNextFELINE BEHAVIORWhere did you get your Camper and how long has he/she been in the family?Is there any PERSON or SITUATION your Camper seems to be uncomfortable with?YesNoIf yes, please describeHas your Camper ever hissed at or bit another PERSON or CAT?YesNoIf yes, what were the circumstances?Can you take a food item away from your Camper without him/her growling?YesNoWill your Camper readily share toys with other cats?YesNoIf no, please describeHas your Camper ever escaped a barrier?YesNoAre there areas on your Camper's body where he/she DOES NOT like to be touched by humans?YesNoIf yes, where?Does your Camper play well with cats of all ages?YesNoIf no, please describe:Is your Camper afraid of thunderstorms?YesNoIf yes, how do we make him/her feel comfortable?Are there any restrictions that should be placed on your Camper's activities?YesNoIf yes, which activities?PreviousNextPlease list persons authorized to drop off and/or pick up your Camper(s):Please place commas between the names of your persons listed.Is there anything else we should know about your Camper?PreviousNextPAWLICY AGREEMENTI give The Lodge Luxury Boarding Retreat permission to care for my Camper during my departure. I have answered the Camper Application to the best of my knowledge. All my Campers vaccinations (FVRCPC, Rabies) are up-to-date and all past medical history is presented above. If vaccines are NOT up-to-date, Animal Hospital of Montgomery and The Lodge has my permission to perform such vaccinations at my expense. If your Camper has never been examined by Animal Hospital of Montgomery, an exam fee of $55.00, plus any additional medical services, will be charged. The Lodge has my permission to do what is necessary should an emergency arise. I acknowledge that The Lodge will exercise all necessary care and precautions to keep my Camper and other participates safe during boarding, daycare, training, and grooming to prevent injury to any person, property, or cat. However, I understand, that because cats are unpredictable animals with their own will and drives, The Lodge cannot protect against every potential injury, risk, or accident. In addition, I acknowledge that The Lodge is not responsible for personal belongings being lost, damaged, or destroyed during my Campers stay. *Yes, I agreeNo, I do NOT agreePlease type your name below for PAWLICY AGREEMENT. Your signature will be required in the office. *PreviousNextFLEA TREATMENT POLICYREQUIRED: I give The Lodge Luxury Boarding Retreat permission to administer a 24-hour flea treatment (Capstar™) upon arrival for boarding at a cost of $8.00. This treatment will not affect ANY monthly heartworm/flea preventatives. *Yes, I give permissionNo, I do NOT give permissionPlease type your name below for FLEA TREATMENT statement. Your signature will be required in the office. *PreviousNextMEDIA OPTIONOPTIONAL: I give The Lodge Luxury Boarding Retreat permission to take and use: photographs and/or digital images of my Camper(s) for use in publicity, illustration, advertising, and web content. I further agree that my name and identity will not be revealed and descriptive text or commentary in connection with the image(s). I authorize the use of these image(s) without compensation to me.Yes, I give permission for mediaNo, I do NOT give permissionPlease type your name below for OPTIONAL MEDIA statement. Your signature will be requested in the office.You are ready to submit your Camper Application!We will review at the office and print your responses to review with you and obtain signatures where needed.Review Previous PagesEmailSubmit
