New Client Form

First Name *

Last Name *

Street Address *

City *

State *

Zip Code *

Owner's Email Address *

Phone Number *

Cell Number *

Driver's License # *

DL State *

Please list your emergency contact, while your pet is boarding.

Emergency Contact 1 *

Emer. Contact Phone 1 *

Emergency Contact 2

Emer. Contact Phone 2

Our system automatically sends Boarding Conformations by email, If you would like text confirmations please indicate the information needed.
Would you like boarding confirmations by text message as well as email ? *

No

Yes

Text Message Number *

Text Message Carrier *

How did you hear about us? Please note that we have a referral program that rewards our current referring clients. Their full name is required for them to receive this gift. *

Advertising

Local Veterinarian

Internet

Family/Friend

Advertising *

Local Verinarian *

Internet / Search Sites *

From a Current Client or Friend *

Please explain Other *

Please Tell Us First & Last Name *

Do you have more than one Veterinarian for your Pets ? *

Yes

No

Pet #1

Name *

Species (dog, cat, etc) *

Breed *

Color *

Sex *

Female

Spayed

Male

Neutered

Birthdate

Weight *

Your Pet(s) Veterinarian *

Veterinarian's Phone Number *

Special Instructions for your pet, this should include any medical condition or medications your pet is on.

0/255 characters

Will You have your own food? *

Yes

No

How often *

AM

PM

Bowl all day

Amount (cups) *

If you have something other than dry food for your pet, please put instructions here.

Do you have Another Pet? *

Yes

No

Pet #2

Name *

Species (dog, cat, etc) *

Breed *

Color *

Sex *

Female

Spayed

Male

Neutered

Birthdate

Weight *

Your Pet(s) Veterinarian *

Veterinarian's Phone Number *

Special Instructions for your pet, this should include any medical condition or medications your pet is on.

0/255 characters

Will You have your own food? *

Yes

No

How often *

AM

Noon

PM

Bowl all day

Amount (cups) *

If you have something other than dry food for your pet, please put instructions here.

Do you have Another Pet? *

Yes

No

Pet #3

Name *

Species (dog, cat, etc) *

Breed *

Color *

Sex *

Female

Spayed

Male

Neutered

Birthdate

Weight *

Your Pet(s) Veterinarian *

Veterinarian's Phone Number *

Special Instructions for your pet, this should include any medical condition or medications your pet is on.

0/255 characters

Will You have your own food? *

Yes

No

How often *

AM

PM

Bowl all day

Amount (cups) *

If you have something other than dry food for your pet, please put instructions here.

Veterinarian Information

Your Pet(s) Veterinarian *

Veterinarian's Phone Number *

If you have your pets Vaccine Info and would like
to send it to us, please upload now.

I certify that the above information is true and that all pertinent information about my pet has been given. I agree not to hold Camp KCS responsible for any problems that arise due to information not given. I also understand that a copy of my pets vaccines must be present at time of check-in and that all vaccines are up to date including Bordetella. By signing on the line below I agree to the terms stated above.

I agree to the statement above.

*