Registration Form

Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Email

Home Phone

Cell Phone

Emergency Contact

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Emergency Contact Phone

How did you hear about us?

Veterinarian?

Your Pets Information:

Name

Breed

Date of Birth

Weight

Color

Sex

Spayed/Neutered

Yes
no

Your Pets Health:

Pet's General Health: (Comment Box)

Grooming Agreement

Owner

First Last

I give Lucky Dog Grooming permission to bathe and groom my pet. I realize that grooming requires the use of scissors and other cutting instruments and that such use may result in injury if the animal being groomed moves suddenly. I understand that if my pet is matted it will require shaving and may uncover pre-existing skin conditions, moles and infections. I understand that when shaving, cuts and scrapes may result because mats are very close to the skin. I understand my pet has a mind of its own and may not cooperate with us causing itself injury. Lucky Dog Grooming and its employees shall not be held responsible for the animal(s) named above. In the event of illness or injury, a qualified veterinarian will be summoned. The owner will pay the cost of medication and veterinarian bill. While every precaution will be taken to prevent accident, injury, fire, sickness, escape, dog fight, death, etc.; animals are placed at Lucky Dog Grooming at the risk of the owner. I agree to the above conditions. *

YES

Name

First Last

Date