Grooming Waiver

Owners Information

Owners Name*

First Last

Email*

Cellular Phone*

Work Phone*

Emergency Phone*

Your Address*

Street Address Address Line 2 City Province Postal Code

Dogs Information

Dogs Name*

Breed*

Date of Birth*

*All dogs over 8 months of age must be neutered/spayed

Sex*

Male
Female

Spade / Neutered ?*

Yes
No

Is this your dogs first groom ?*

Yes
No

Consent*

Veterinary Information

Vets Name*

Vets Address*

Vets Phone*

Medical Conditions*

None
Epilepsy
Hip Dysplasia
Arthritis
Heart Disease
Other

Medications

Behavioural Issues?

Behaviour*

Does your dog have any separation anxiety from you?

Kibble*

Food Allergies*

Digital Signature

I Certify:

that I am eighteen years of age or older and have the legal capacity to enter into a binding contract. Further, I certify that I have read and understood the rules and regulations as set forth in this agreement. I agree to abide by the rules and regulations and accept all terms, conditions and statements of this agreement.

Signature*

Date Signed*

Name

This field is for validation purposes and should be left unchanged.

Good Hound Village

Good Hound Country

604-946-8724

Email Us

Grooming Waiver

Owners Information

Dogs Information

Veterinary Information

Digital Signature