Penny's Pooches LogoPenny's Pooches
Back to Forms

Declaration Form

Ahead of each and every boarding period a new Declaration Form must be submitted. This is a condition of the licence arrangements and ensures the dog, the business and our clients are all protected.

Prefer to complete it offline? Download the Declaration Form as a Word document and email it to [email protected].

Download (.docx)

Fields marked with * are required.

This is the same as the Quote Reference.

Emergency Contact

?
Someone that can be contacted and, where necessary, provide ongoing care for the dog in the absence of the client.

Board Details

These details should exactly match the details of the accepted Quote. This Declaration Form is not the opportunity to request changes to the agreed boarding arrangements. If changes need to be made to dates, times or handover arrangement, please contact Penny's Pooches directly to discuss.
Board Type *

Your Dog

Vaccination Status

?
Vaccines must be licensed for use in the UK. Core boosters (Parvo/Distemper/Adenovirus) should be within the last 3 years; Leptospirosis and Kennel Cough within the last 12 months. A recent (less than 12 months) titre testing certificate may be accepted in lieu of core boosters.

I can confirm, for all dogs included on this Declaration Form, that they are all in date for the following vaccinations:

Treatment for External and Internal Parasites

Indication of parasites at handover may result in refusal to board.

I can confirm, for all dogs included on this Declaration Form, that they are all in date for parasite treatment:

Consent and Declarations

Please select Yes or No for each statement below. Where the declaration is not the same for all dogs, please provide detail.

Statement 1: I consent for my dog(s) to take their meals with other dogs ... at feeding times *
Statement 2: I consent for my dog(s) to take exercise with other dogs in outdoor spaces *
Statement 3: I require my dog(s) to be segregated from other dogs ... at feeding times *
Statement 4: I require my dog(s) to be segregated from other dogs ... when using outdoor spaces *
Statement 5: I require my dog(s) to be segregated from other dogs ... during rest indoors *
Statement 6: I consent for my dog(s) to be walked away from the boarding home *
Statement 7: I consent for my dog(s) to be walked with other dogs *
Statement 8: I consent for my dog(s) to be walked off the lead *
Statement 9: I consent to the use of Penny's Pooches provided collar/harness/lead *
Statement 10: The Pooch Passport(s) submitted by me, and so dated, provide accurate and complete detail of my dogs' needs and routines. Any small changes have been detailed at the bottom of this Form. *

Boarding cannot go ahead unless you can answer Yes to each of the following:

Statement 11: I consent for my dog(s) to be boarded with other dogs at the boarding home *
Statement 12: I accept the quote referenced and I accept the terms and conditions outlined. *
Statement 13: I acknowledge that during boarding, medical care may be sought from an alternative vet. Whilst every effort will be made by the licencee to contact me before any treatment is given, I accept that unconsented medical treatment from a competent person may be necessary and that the cost of any such treatment is additional to any agreed boarding fee. *
Statement 14: I confirm that the Emergency Contact has been instructed by me and understands their responsibility towards onward care of the dog either:
  • if the Board needs to be terminated early for any reason
  • at the end of the Board if I remain unavailable and the Board cannot be extended
*
Statement 15: I declare that all information provided in this form is accurate and complete. *

Client Signature

Items Provided at Handover

Changes Since Your Pooch Passport(s)