Windhoek Pet Lodge Information Form Information about your Dog PLEASE CLICK SUBMIT WHEN YOU FINISH THE FORM, THIS FORM IS NOT THE BOOKING, YOU NEED TO FOLLOW THE NEXT STEPS AFTER COMPLETING AND SUBMITTING THE FORM Name of Owner* First Last Email* Home Address* Street Address Address Line 2 City Phone*Phone 2In case Phone 1 is unavailable.Number of Dogs* 1 2 3 4 5 Dog 1* Name Sex Breed Dog 1* Age Neutered Yes/No Weight Dog 2* Name Sex Breed Dog 2* Age Neutered Yes/No Weight Dog 3* Name Sex Breed Dog 3* Age Neutered Yes/No Weight Dog 4* Name Sex Breed Dog 4* Age Neutered Yes/No Weight Dog 5* Name Sex Breed Dog 5* Age Neutered Yes/No Weight Where did you hear about us:*Medication and instructions:Veterinary Expenditure*maximum amount if we cannot get hold of you to confirmEscape behaviour:* YES NO eg jumping fenceMy dog is well-socialised with other dogs.* YES NO I DO NOT KNOW (meaning your dog goes to places where it has interaction with other dogs) this does not mean that your dog regularly visits the same dog of a friend...My dog is well socialized with other people* YES NO I DO NOT KNOW (meaning your dog is used to other people handling/touching them apart from your own family)If your answer is NO above you will need to accept the following Terms and Conditions:* I hereby accept and understand Protocol used by Windhoek Pet Lodge for possible aggression towards any of the Pet Lodge Staff. Failure as a pet owner to properly expose/socialize a young dog to various races and all ages of people will result in your dog being scared. That in turn leads to possible aggression if we force ourselves onto your dog to touch them or want them to follow us for a walk or simply come with us inside to their rooms. The outcome is we have no control over your dog to keep them safe and happy. We have tested procedures working with food to get them to trust us, but it might take as long as 1 to 5 days where in that period they will stay in their room until such time they eat voluntarily out of our hands. You hereby agree to accept the protocol that Windhoek Pet Lodge uses and will refrain from slandering the Pet lodge name or reputation due to perceived cruelty.Anything else about your dog that we should know:* It is my responisibility/ choice to use tick treatments if needed. * I have provided Windhoek Pet Lodge with the correct information about my dog to the best of my knowledge. * I accept all Terms and Conditions AND Cancelation Policy Date*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Signature*