Customer Name*

Email Address*

Phone Number(s)*

1st Emergency Contact Name*

1st Emergency Contact Phone*

2nd Emergency Contact Name (optional)

2nd Emergency Contact Phone (optional)

Date of Arrival (dd/mm/yy)*

Date of Departure (dd/mm/yy)*

Pet* Pet* Cat Dog

Pet's Name*

Breed of pet*

Pet's D.O.B./Age*

Pet's Sex* Pet's Sex* Male Female

Pet Neutered/Spayed?* Pet Neutered/Spayed?* Yes No

Pet's Microchip Number

Pet's Flea & Worm Treatment (dd/mm/yy)

Pet Requires Medication?* Pet Requires Medication?* Yes No

If you have answered yes, please provide details of the medication and instructions for administering the same.

All Dogs and Cats are fed on our Royal Canin complete dry food, we can also provide an assortment of tins/pouches of wet food if necessary. Customers are welcome to bring their own food, if preferred. Please give details of type/frequency/quantity.

Notes: Any Scars, Lumps and Bumps, Behavioural issues, Allergies, Illness's, Food Guarding/Feed Seperate etc.

Vets Practice*

Vets Phone Number*

Please bring your up to date Inoculation Card with you on your day of booking. Please bring your up to date Inoculation Card with you on your day of booking. -

If any pet requires Veterinary treatment whilst Boarding with us we reserve the right to use our Vets (Nantwich Veterinary Practice) who we have on 24 hour call. By signing and completing this form, you are giving us permission to act on your behalf and to authorise the vet to undertake any necessary treatment advised. **Please note : We will always take every step reasonably possible to contact you in such circumtances on the contact numbers provided. If any pet requires Veterinary treatment whilst Boarding with us we reserve the right to use our Vets (Nantwich Veterinary Practice) who we have on 24 hour call. By signing and completing this form, you are giving us permission to act on your behalf and to authorise the vet to undertake any necessary treatment advised. **Please note : We will always take every step reasonably possible to contact you in such circumtances on the contact numbers provided. -

Please note that all pets must be fully up to date with vaccinations, this must include the Kennel Cough vaccine for dogs. Failure to provide proof of up to date inoculations will lead to Boarding being refused. You can email a scan or photo of your pet's inoculations to thegrangekennels@gmail.com. Please note that all pets must be fully up to date with vaccinations, this must include the Kennel Cough vaccine for dogs. Failure to provide proof of up to date inoculations will lead to Boarding being refused. You can email a scan or photo of your pet's inoculations to thegrangekennels@gmail.com. -

I confirm that I have agreed to the Terms & Conditions (to view click here) of The Grange Kennels Limited and in particular condition's 9 and 10. I further confirm that the details provided above are true and accurate in all respects. (Our T's and C's can also be found on our website www.thegrangekennels.co.uk). I confirm that I have agreed to the Terms & Conditions (to view click here) of The Grange Kennels Limited and in particular condition's 9 and 10. I further confirm that the details provided above are true and accurate in all respects. (Our T's and C's can also be found on our website www.thegrangekennels.co.uk). I have read and understood the T&Cs