1912 Picadilly Avenue
Round Rock, TX 78664
512-989-6767 (phone/text)
512-989-9769 (fax)
info@hiphounds.com
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New Customer Information
Please provide the requested information below.
Depending on how many dogs you have, it should only take you five to ten minutes to complete this form
Page one is information about you and the following pages are information about your dog(s).
If you have any questions, please feel free to contact us at 512-989-6767 or you can email us at
info@hiphounds.com
Date
*
Email
*
Name
*
First
Last
Address
Street Address
Address Line 2
City
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Colorado
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Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Mobile Phone
*
Home Phone
Emergency Contact (someone other than yourself)
First
Last
Emergency Contact Phone Number
How did you hear about Hip Hounds
*
Google Search
Yelp
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Drive By
From a Friend/Neighbor/Co-Worker
If a friend or co-worker referred you, please let us know their name
What vet clinic do you use?
How many dogs will you be bringing to Hip Hounds?
*
1
2
3
4
5
Vaccination Records
If you have vaccination records you'd like to send us, you can upload them here. If you're bringing multiple dogs, you can upload all dog's vaccination records here. All dogs must be current on Rabies, Bordetella, Distemper and Parvo vaccinations. You can also have them faxed to us at 512-989-9769 or email them to us at info@hiphounds.com
Drop files here or
First Dog's Information
Dog's Name
Breed
*Due to a clause in our lease, we are not able to accept American Pit Bull Terriers, American Staffordshire Terriers, American Bullys, Staffordshire Bull Terriers, wolves or wolf hybrids.
Color
*please include dog's primary and secondary colors
Birth Date
( we realize that you may not know your dog's exact birth day. A month and year, or your best guess, are fine )
MM
DD
YYYY
Sex
*
*because of our group play environment, all dogs over nine months of age must be spayed or neutered
Spayed Female
Neutered Male
Intact Female ( 9 months old or younger )
Intact Male ( 9 months old or younger )
Medical Conditions/Allergies
Please indicate below any medical conditions or allergies your dog may have.
Additional Dog Information
Please let us know any additional information regarding your dog's behavior, quirks or preferences below.
Second Dog's Information
Second Dog's Name
Breed
*Due to a clause in our lease, we are not able to accept American Pit Bull Terriers, American Staffordshire Terriers, American Bullys, Staffordshire Bull Terriers, wolves or wolf hybrids.
Color
*please include dog's primary and secondary colors
Birth Date
( we realize that you may not know your dog's exact birth day. A month and year, or your best guess, are fine )
MM
DD
YYYY
Sex
*
*because of our group play environment, all dogs over nine months of age must be spayed or neutered
Spayed Female
Neutered Male
Intact Female ( 9 months old or younger )
Intact Male ( 9 months old or younger )
Medical Conditions/Allergies
Please indicate below any medical conditions or allergies your dog may have.
Additional Dog Information
Please let us know any additional information regarding your dog's behavior, quirks or preferences below.
Third Dog's Name
Breed
*Due to a clause in our lease, we are not able to accept American Pit Bull Terriers, American Staffordshire Terriers, American Bullys, Staffordshire Bull Terriers, wolves or wolf hybrids.
Color
*please include dog's primary and secondary colors
Birth Date
( we realize that you may not know your dog's exact birth day. A month and year, or your best guess, are fine )
MM
DD
YYYY
Sex
*
*because of our group play environment, all dogs over nine months of age must be spayed or neutered
Spayed Female
Neutered Male
Intact Female ( 9 months old or younger )
Intact Male ( 9 months old or younger )
Medical Conditions/Allergies
Please indicate below any medical conditions or allergies your dog may have.
Additional Dog Information
Please let us know any additional information regarding your dog's behavior, quirks or preferences below.
Fourth Dog's Name
Breed
*Due to a clause in our lease, we are not able to accept American Pit Bull Terriers, American Staffordshire Terriers, American Bullys, Staffordshire Bull Terriers, wolves or wolf hybrids.
Color
*please include dog's primary and secondary colors
Birth Date
( we realize that you may not know your dog's exact birth day. A month and year, or your best guess, are fine )
MM
DD
YYYY
Sex
*
*because of our group play environment, all dogs over nine months of age must be spayed or neutered
Spayed Female
Neutered Male
Intact Female ( 9 months old or younger )
Intact Male ( 9 months old or younger )
Medical Conditions/Allergies
Please indicate below any medical conditions or allergies your dog may have.
Additional Dog Information
Please let us know any additional information regarding your dog's behavior, quirks or preferences below.
Fifth Dog's Name
Breed
*Due to a clause in our lease, we are not able to accept American Pit Bull Terriers, American Staffordshire Terriers, American Bullys, Staffordshire Bull Terriers, wolves or wolf hybrids.
Color
*please include dog's primary and secondary colors
Birth Date
( we realize that you may not know your dog's exact birth day. A month and year, or your best guess, are fine )
MM
DD
YYYY
Sex
*
*because of our group play environment, all dogs over nine months of age must be spayed or neutered
Spayed Female
Neutered Male
Intact Female ( 9 months old or younger )
Intact Male ( 9 months old or younger )
Medical Conditions/Allergies
Please indicate below any medical conditions or allergies your dog may have.
Additional Dog Information
Please let us know any additional information regarding your dog's behavior, quirks or preferences below.
Mijeli Enterprises, LLC dba Hip Hounds
1. I understand that I am responsible for any harm caused by my dog while my dog is attending Hip Hounds. I shall indemnify Mijeli Enterprises LLC against any claims made against the company or losses or damages of any kind suffered by Mijeli LLC as a result of my failure to inform Hip Hounds of any pre-existing condition the dog may have (such as illness or aggression problems.) I understand and agree that in admitting my dog to Hip Hounds the facility has relied on my representation that my dog is in good health and has not harmed or shown aggressive or threatening behavior towards any person or any other dog.
2. I understand and agree that Mijeli Enterprises LLC will not be liable for problems, damage, or injury caused by my dog provided reasonable care and precautions are followed by day care staff. I understand that Mijeli Enterprises LLC is fully insured. I release Mijeli Enterprises LLC of any liability arising from my dog’s attendance and participation at the daycare. I understand that the day care is a place where animals co-mingle in groups. I understand my animal may be placed in a crate for "time outs" not to exceed twenty minutes, for overnight care or if injured. Squirt water bottles may be used for correction. I understand that when dogs play in groups, nicks and scratches may occur. Day care staff may or may not notify me immediately. If the injury is not serious staff may feel it is ok to leave the dog until the end of the day and let me know about it when I pick up. If the injury is serious I will be notified immediately.
3. I understand that my dog may be transported for instances such as medical care or in case of any emergency. The transport service is required to carry all appropriate insurance and I will hold Mijeli Enterprises LLC harmless in the event of injury or accident while being transported.
4. I understand and agree that any problem or injury that develops with my dog will be treated as deemed best by Hip Hounds. Either my veterinarian or a nearby veterinarian will be contacted in the event of a medical problem that is serious in nature.
5. I understand that if my dog is left at the day care for a period of thirty days without contact from the owner this dog will be considered abandoned and necessary steps will be taken to turn the animal over to the proper authorities.
6. I recognize that there are inherent risks of illness or injury when dealing with co-mingling animals. Such risks include, but are not limited to; problems or injuries resulting from rough dog play, outdoor play, kennel cough and associated upper respiratory infections and canine influenza.
7. I, as the owner, agree to be solely responsible for any and all acts or behavior of my pet while in the care of Hip Hounds. If my pet should become ill or seem to be in need of medical consideration, Hip Hounds reserves the right to administer aid and/or to use any available veterinarian. I, the owner, shall pay any expenses so incurred.
8. I understand that any items I bring ( bedding, towels, toys, etc. ) are brought at my own risk and that Hip Hounds cannot guarantee that they will be returned in the same condition in which they were brought. Hip Hounds is not responsible for any lost or destroyed personal items.
9. I understand that it is my responsibility to inquire about current boarding rates, pickup times and any additional charges that I may incur during my dog’s stay at Hip Hounds.
Owner's Name
*
*
I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.
Please let us know if you have any questions or concerns.
You can call Hip Hounds at 512-989-6767
Or email us at
info@hiphounds.com