Enrollment

"*" indicates required fields

Step 1 of 5 - General Owner Information

20%

Owners*

First Name

Last Name

Address*

Street Address City State ZIP Code

Primary Contact Name:*

Primary Contact Phone Number:*

Please enter the cell phone number that you wish to receive important phone calls, text message appointment confirmations and reminders at.

Leader of the Pack Canine Institute's Privacy Policy*

I agree to the privacy policy.

Leader of the Pack Canine Institute, LLC maintains strict privacy policies to protect the personal information of our users obtained for text message communications. This information is never sold, rented, released, or traded to others without prior consent or legal obligation. No mobile information will be shared with third parties/affiliates for marketing/promotional purposes. Any sharing of information with third parties is solely for the purpose of fulfilling the organization's obligations to the user.
By submitting your phone number, you are authorizing us to send you text messages and notifications. Message/data rates apply. If you are receiving text messages from us and wish to stop receiving them, simply respond with STOP to the number from which you received the message. Once we receive your message, you will no longer receive further text messages from us unless opting back in by replying again with SUBSCRIBE.

Secondary Contact Name:

Secondary Contact Phone Number:

Email*

Emergency Contact(s) (Not in Same Household)*

Name

Phone

Relationship

Approved Person(s) for Pick Ups/Drop Offs: (Not in Same Household)

Name

Phone

Relationship

Dog’s Name*

Dog's Breed*

Dog's Color*

Dog's Weight*

Dog's Gender*

Dog's Birth Date*

Fixed (Neutered/Spayed) *REQUIRED FOR DAYCARE IF OVER 6 MONTHS**

Yes

Fixing (Spaying/Neutering) Appointment Date

Veterinary Clinic*

Referral*

How did you hear about Leader of the Pack?

Friend / Family referral

Vet Office

Internet Search

Radio Advertisment

Newspapers

Facebook

Sign

Magazine

Bill board

Other

Give Barking Buddy Referral Point To:

Please list the First & Last Name of the person who referred you. If they are in our system, they will receive a Barking Buddy Point for referring you. Ask a customer service representative for more information about our BBP referral system!

Please describe how you heard about us.*

Dog License

Number

County

While a dog license is not required for enrollment in our services, they are required by law. We highly recommend getting a dog license to avoid the possibility of being fined.

Microchip

Microchip Number

Brand

Does Your Dog Visit Dog Parks?*

Yes

When Was The Last Time Your Dog Visited A Dog Park?*

Yearly Heartworm Test?*

Yes

Flea and Tick Medication?*

Yes

Describe any medical/health issues we need to be aware of: (i.e. seizures, heart/hip problems, etc.)*

Please list any known allergies that your dog has:*

Please list any medications your dog is currently taking:

Select the items that you will provide to assist our staff when administering your pets medications:*

Peanut Butter

Pill Pockets

Cheese Slices

Deli Meats

Canned Dog Food

*Please be sure to bring only enough medications for your pets stay. At check-in, please be specific when explaining your pets medication schedules and be sure to mention any sensitivities or allergies they may have. Thank you!

How long has your dog been in your family?*

Where did you get your dog?

Is Your Dog Adopted?*

Yes

Past History (If Known)*

Has your dog had any obedience training?*

Yes

Obedience Training Level*

Beginner

Advanced

CGC

TDI

Agility

Has your dog ever been enrolled in daycare before?*

Yes

If yes, where?

Do you use a crate?*

Yes

Are they comfortable in the crate?*

Yes

Is your dog comfortable with having his/her feet touched?*

Yes

I'm not sure

Is your dog comfortable with having his/her collar used to lead?*

Yes

I'm not sure

Has your dog ever climbed or jumped a fence?*

Yes

I'm not sure

Has your dog ever growled or snapped at anyone who’s touched his/her bones, food or toys?*

Yes

I'm not sure

Does your dog play with other dogs on a regular basis?*

Yes

Would you say he/she plays nicely?*

Yes

Please Describe issues with your pet(s) play style that the staff would need to know.

Does your dog prefer certain sexes of dogs?*

Yes

Which sex?*

Male

Female

Does your dog automatically dislike any kind of dog?*

Yes

What kinds?*

How does your dog react to puppies?*

Happy to see them

Go away I don’t like you

Indifferent to them

How does your dog react to strangers?*

Happy to see them

Go away I don’t like you

Indifferent to them

Does your dog automatically dislike any kind of person?*

Yes

What kinds?*

Describe any behavioral problems/idiosyncrasies/special sensitivities we should be aware of*

IF ANY OF THE ABOVE INFORMATION CHANGES, PLEASE NOTIFY US IMMEDIATELY!

Rules and Regulations*

I have read and agree to LOPCI's Rules and Regulations

To ensure the safety and health of all animals, customers, and staff at Leader of the Pack Canine Institute LLC (LOPCI) Dog Daycare and
Boarding, Programs and Facility, we require all clients to comply with the following Rules and Regulations:

SEX: All dogs must be spayed or neutered (unless they are under 6 months of age) to be in the open play environment. All dogs can attend
the pack environment after neutering or spaying but must wait 4 weeks after surgery before attending. Dogs over 6 months of age that are not
spayed/neutered, can still attend daycare or boarding, but will not be allowed to play in the playrooms with other dogs. For dogs that are not
spayed and over the age of 6 months, please provide us with your dog’s heat cycle if known. Female dogs cannot be in at Leader of the Pack
Canine Institute LLC while in heat. After a heat cycle, a bath is required before entering the facility.

SHOTS: Parents must submit written verification that their dogs have current vaccines for Distemper, Hepatitis, Leptosipirosis,
Parainfluenza, Parvovirus, Rabies, Canine Influenza, and Bordetella. All vaccinations must be administered by a licensed veterinarian.
Breeder vaccination records will be accepted for puppies. Vaccinations records must be clear and visible. It is your responsibility to provide
ongoing verification of current vaccinations. You may be charged a “special needs fee” if it is necessary for our staff to secure verification. In
addition to current vaccinations all dogs must have a negative stool sample test in the last six months. If your dog is under the age of 4
months, you must provide the second round of puppy shots (Distemper and Bordetella). Owner understands that even though the animal is up
to date on vaccines there is always the possibility of contracting a common virus and that LOPCI cannot be responsible or liable for any such
issue.

HEALTH: All dogs must be in good health. By completing the Leader of the Pack Client Agreement and bringing your dog into LOPCI, you
are certifying that your dog(s) are in good health and have been free from any condition that could potentially jeopardize them or other
guests. Dogs that have been ill with a communicable condition in the last 30 days will require veterinarian certification of health to be
admitted or readmitted. If at any time during care, a dog is noticed to have fleas or ticks, treatment will be applied and charged to the parent.
Dogs must have a flea and parasite preventative applied, excluding flea/tick collars. Please wait 24 hours after applying flea/tick preventative
medicines before bringing your pet in for daycare or boarding.

FOOD: All food brought to Leader of the Pack Canine Institute LLC Dog Daycare and Boarding Facility must be stored in a labeled airtight
proof container. Plastic baggies or open dog food bags are not acceptable.

BEHAVIOR: All dogs must pass the Leader of the Pack Canine Institute LLC Behavior Assessment for enrollment in our programs. All dogs
must be non-aggressive and not food or toy protective. Parents will need to certify that their dog(s) have not harmed or shown any aggression
or threatening behavior towards any person or any other dog(s). Please remember that your pet will be spending time with other pets and their
safety and health is our main priority. Keep in mind, although it is supervised play, your dog still might acquire an occasional nip or scratch.
LOPCI at its sole discretion may remove or disqualify any dog that LOPCI deems as a danger to our guests. Separated dogs may incur
additional fees.

AGE: Any age dog/puppy is allowed at Leader of the Pack Canine Institute LLC Daycare Facility if the dog/puppy meets the Facility’s
criteria. For pack interaction and play, puppies may begin at Leader of the Pack Canine Institute LLC Daycare and boarding Program before
they receive their Rabies vaccine and before they are spayed/neutered. Dogs that are 4 months of age or older must provide proof of up-todate Rabies vaccination. Dogs that are 6 months and older and not neutered or spayed may not be in the pack environment.

ENROLLMENT: All dogs must have a complete, up-to-date, and approved enrollment form on file. If your dog has been out of daycare for 6
months or more, re-assessment is required, and fees will be applied. ALL REQUIRED FORMS MUST BE SIGNED BY PARENT BEFORE
ENROLLMENT. Signee must be at least 18 years of age. Leader of the Pack Canine Institute LLC will not release any pet to an unauthorized
party. All authorized parties must be communicated with Leader of the Pack Canine Institute LLC prior to any arrangements made for pick
up.

FEES/CHARGES: Due and payable at the end of each day. Fees and charges may include but are not limited to, boarding, private stay,
daycare, transportation, veterinary, feeding, medication administration, baths, nails, grooming, ala carte, late fees, evaluations, training, etc.
Cash, checks or MasterCard/Visa/Discover/American Express are accepted. Discounted packages are provided only if they are paid in
advance. Pre-paid packages are non-refundable. Published fees and charges are subject to change without notice.

HOURS OF OPERATION: Monday through Friday 6:30am to 7:00pm. Saturday and Sunday 8:00am to 6:00pm. Drop off and pick up for
daycare is available any time during these hours. Daycare closes promptly at 7:00 pm Monday through Friday and at 6:00pm Saturday and
Sunday. A late charge will be applied for any preapproved daycare pickups after 7:00pm. Boarding drop offs and pick-ups must be before
6:00pm Monday through Friday and before 5:00pm Saturday and Sunday, or a late fee will apply. Holiday hours may vary with drop off and
pick up at specified times.

Rules and Regulations, Prices, and Hours are subject to change at any time

Rules And Regulations Form*

I Have Read And Agree To LOPCI's Rules And Regulations

To print our Rules and Regulations page for your own records, please click this link. By checking this box you attest that you have read and agree to LOPCI's Rules and Regulations Form.

Signature (Signee acknowledges the Rules and Regulations Form has been read and agreed upon. Signee must be at least 18 years of age)*

Client Agreement Form*

I agree to LOPCI's Client Agreement Form

I request that my dog(s) be accepted into the Leader of the Pack Canine Institute LLC (LOPCI) Dog Daycare and/or boarding and
additional activities or program(s). In accepting my dog(s) into the Program(s), I acknowledge that Leader of the Pack Canine Institute
LLC will be relying on my understanding and agreement with the provisions of this “Client Agreement”. I understand and agree that
this “Client Agreement” contains a limitation of liability:

*Every dog reacts differently and animals by nature are unpredictable and therefore present a certain level of risk. I acknowledge and
understand that there are certain risks involved in participating in daycare, boarding, or other Program(s) and in owning, training,
caring for, handling, and being in the presence of dogs. Including, but not limited to, damage or injury to people, property and animals,
dog fights, dog bites to humans or other dogs and the transmission of disease.

*In case of emergency or need for medical attention, I authorize the staff and agents of LOPCI to take appropriate action in their sole
discretion for the care of my dog(s) and that this action may include transport to and or care at another Facility or necessary location. I
recognize the risk of injury that may accompany said transport and or care and authorize such transport and or care without liability to
LOPCI staff and agents. I accept all conditions, rules and regulations promulgated by the caring Facility associated with the activities,
use of the Facility, and transport, and hereby agree to comply with them. I understand and agree that upon entry or transfer to another
Facility I will be relying on said Facility for the care of my dog(s) and assume full financial responsibility for payment or expenses to
said Facility for all treatment(s) given.

*Dogs not familiar with the LOPCI may experience separation anxiety when apart from their human companions.

*Dogs not regularly exposed to the level of activity at the LOPCI may feel discomfort of sore muscles, sore joints, and fatigue. Dogs
not regularly exposed to outside activity or play on hard surfaces may experience sore paws, blisters, bruises, or abrasions on the feet
(Raw Paw).

*Dogs not regularly socialized do not necessarily know how to behave politely with other dogs. These dogs are at higher risk of
incidents including, but not limited to, bites, fights, fear aggression, object guarding, and behavior problems and/or acting out.

*Dogs at play during the regular daycare, boarding, activities, or Program(s) get dirty. Dogs with longer hair can get matted from the
level of activity at LOPCI. Baths and brush outs can be requested and scheduled at pet owner’s expense. Excessively long nails may
cause injury. I will be notified if my dog’s nails are too long. If, at my next visit, the nails have not been trimmed, the Facility will
have them trimmed at my expense. Should LOPCI staff at their sole discretion deem it necessary to bath a dog for sanitary or health
reasons, I agree to authorize this action and accept responsibility for payment of such service.
There are extra risks to my dog of contracting diseases by entering the daycare or boarding program without being fully vaccinated.

*Dogs that are vaccinated can still contract diseases. Dogs with a lower immune system are more susceptible to contracting diseases.

*Water is always available; however, my dog may still by thirsty after attending LOPCI. I will be aware of their water intake as
excessive amounts may cause an upset stomach or other problems.
Dramatic changes in food and/or food quality may cause upset stomach, diarrhea, and/or colitis. Please provide adequate food during
your dog(s) stay. I authorize LOPCI to feed my dog(s) LOPCI house food at the applicable charge, should they run out of food.

*Any behavior deemed dangerous or inappropriate by LOPCI personnel may result in dismissal of my dog(s) from LOPCI and the
Program(s). Any determination of LOPCI personnel at their sole discretion will be final and have authority.

*I understand that I am solely responsible for any harm caused by my dog(s) while my dog(s) is attending LOPCI.
I must pay for all services at the time they are rendered. Fees and charges that may apply include, but are not limited to, boarding,
private stay, daycare, transportation, veterinary, feeding, medication administration, baths, nails, grooming, ala carte, late fees,
evaluations, training, etc. I understand any unpaid charges or fees by me will be sent to collections, and I will be responsible for all
collections and legal fees incurred by such actions taken.

*In admitting my dog(s) into LOPCI, LOPCI has relied on my representation that my dog(s) is/are in good health and has/have not
harmed or shown aggressive or threatening behavior towards any person or any other dog.

*I understand and agree that all pet(s) must
be in good physical condition and that Leader of the Pack reserves the right to remove or refuse service to any pet(s) that they deem to
be of risk to themselves or other guests.

*I understand that LOPCI staff give all pets involved in any type of incident a cursory examination, however, LOPCI’s staff are not
trained veterinarians and will not be liable for the location, treatment or diagnosis of any injuries incurred. If my dog(s) is/are involved
in an incident at LOPCI, I will check my dog(s) further to seek treatment for my dog(s) by a licensed veterinarian at my discretion and
cost.

*Photographs, videotape, or digital recordings are taken of the facility, dogs, customers, and staff on a regular basis for, among other
things, use in advertising by Leader of the Pack Canine Institute LLC. I acknowledge that all such images (electronic, negatives and
positives), together with prints and the copyrights therein, are the property of Leader of the Pack Canine Institute LLC. I give Leader
of the Pack Canine Institute LLC and persons authorized by Leader of the Pack Canine Institute LLC my consent, permission, and
authorization, without compensation to me, to use, reproduce and alter the images, in print or electronic format (including on the
internet), either alone or in combination with other images, text and graphics. I waive my right to approve the finished photograph,
advertising copy, print material or electronic files that may be used in conjunction with the images.

*I represent that I am at least 18
years of age and acknowledge that the rights granted in this paragraph are irrevocable worldwide, and perpetual and are binding on the
heirs, successors and assigns.

*I have read all the above and I understand and agree to the terms contained in this Client Agreement. I also acknowledge that I have
read and understand the rules contained in LOPCI document “Rules and Regulations”.

Client Agreement Form*

I have read and agree to LOPCI's Client Agreement

To print our Client Agreement Form for your own records, please click this link. By checking this box you attest that you have read and agree to LOPCI's Client Agreement.

Signature (Signee acknowledges the Client Agreement Form has been read and agreed upon, Signee must be at least 18 years of age)*

Waiver and Release of Liability*

I agree to LOPCI's Waiver and Release Form

Waiver and release of Leader of the Pack Canine Institute, LLC: Animal behavior can be
unpredictable and participation in Leader of the Pack Canine Institute, LLC training,
education, obedience classes, daycare, boarding, grooming, transportation, or any
activities associated with Leader of the Pack Canine Institute, LLC. is not a guarantee of
your pet’s future behavior or safety. By signing this form, you acknowledge that you and
anyone involved on your behalf, understands the risks associated with dogs and dog
activities. You hereby release and hold Leader of the Pack Canine Institute, LLC its
owners, employees, associates, contractors, and heirs harmless for any and all claims of
any kind including bodily injury to you, other persons, animals, or property, whether such
injury or damage occurs during or after any activity, transporting or at any time in the
future. Leader of the Pack Canine Institute, LLC shall not be liable in contract or tort
(including negligence and strict liability) for any indirect, special, incidental, or
consequential damages arising out of or in connection with its performance, nonperformance or otherwise.

Waiver And Release Form*

I have read and agree to LOPCI's Waiver and Release Form

To print our Client Agreement Form for your own records, please click this link. By checking this box you attest that you have read and agree to LOPCI's Client Agreement.

Signature (Signee acknowledges that the Waiver and Release of Liability Form has been read and agreed upon, Signee must be at least 18 years of age)*

Signature (Signee acknowledges all forms have been read and agreed upon, Signee be at least 18 years of age)*

Upload vaccination records below:

Drop files here or

Max. file size: 64 MB, Max. files: 10.

Upload your dog's picture below:

Drop files here or

Max. file size: 64 MB, Max. files: 10.

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If you wish to print and scan the enrollment form instead, you can access the PDF versions here:

"*" indicates required fields

Step 1 of 5 - General Owner Information

20%

Owners*

First Name

Last Name

Address*

Street Address City State ZIP Code

Primary Contact Name:*

Primary Contact Phone Number:*

Please enter the cell phone number that you wish to receive important phone calls, text message appointment confirmations and reminders at.

Leader of the Pack Canine Institute's Privacy Policy*

I agree to the privacy policy.

Secondary Contact Name:

Secondary Contact Phone Number:

Email*

Emergency Contact(s) (Not in Same Household)*

Name

Phone

Relationship

Approved Person(s) for Pick Ups/Drop Offs: (Not in Same Household)

Name

Phone

Relationship

Dog’s Name*

Dog's Breed*

Dog's Color*

Dog's Weight*

Dog's Gender*

Dog's Birth Date*

Fixed (Neutered/Spayed) *REQUIRED FOR DAYCARE IF OVER 6 MONTHS**

Yes

Fixing (Spaying/Neutering) Appointment Date

Veterinary Clinic*

Referral*

How did you hear about Leader of the Pack?

Friend / Family referral

Vet Office

Internet Search

Radio Advertisment

Newspapers

Facebook

Sign

Magazine

Bill board

Other

Give Barking Buddy Referral Point To:

Please describe how you heard about us.*

Dog License

Number

County

While a dog license is not required for enrollment in our services, they are required by law. We highly recommend getting a dog license to avoid the possibility of being fined.

Microchip

Microchip Number

Brand

Does Your Dog Visit Dog Parks?*

Yes

When Was The Last Time Your Dog Visited A Dog Park?*

Yearly Heartworm Test?*

Yes

Flea and Tick Medication?*

Yes

Describe any medical/health issues we need to be aware of: (i.e. seizures, heart/hip problems, etc.)*

Please list any known allergies that your dog has:*

Please list any medications your dog is currently taking:

Select the items that you will provide to assist our staff when administering your pets medications:*

Peanut Butter

Pill Pockets

Cheese Slices

Deli Meats

Canned Dog Food

How long has your dog been in your family?*

Where did you get your dog?

Is Your Dog Adopted?*

Yes

Past History (If Known)*

Has your dog had any obedience training?*

Yes

Obedience Training Level*

Beginner

Advanced

CGC

TDI

Agility

Has your dog ever been enrolled in daycare before?*

Yes

If yes, where?

Do you use a crate?*

Yes

Are they comfortable in the crate?*

Yes

Is your dog comfortable with having his/her feet touched?*

Yes

I'm not sure

Is your dog comfortable with having his/her collar used to lead?*

Yes

I'm not sure

Has your dog ever climbed or jumped a fence?*

Yes

I'm not sure

Has your dog ever growled or snapped at anyone who’s touched his/her bones, food or toys?*

Yes

I'm not sure

Does your dog play with other dogs on a regular basis?*

Yes

Would you say he/she plays nicely?*

Yes

Please Describe issues with your pet(s) play style that the staff would need to know.

Does your dog prefer certain sexes of dogs?*

Yes

Which sex?*

Male

Female

Does your dog automatically dislike any kind of dog?*

Yes

What kinds?*

How does your dog react to puppies?*

Happy to see them

Go away I don’t like you

Indifferent to them

How does your dog react to strangers?*

Happy to see them

Go away I don’t like you

Indifferent to them

Does your dog automatically dislike any kind of person?*

Yes

What kinds?*

Describe any behavioral problems/idiosyncrasies/special sensitivities we should be aware of*

IF ANY OF THE ABOVE INFORMATION CHANGES, PLEASE NOTIFY US IMMEDIATELY!

Rules and Regulations*

I have read and agree to LOPCI's Rules and Regulations

Rules And Regulations Form*

I Have Read And Agree To LOPCI's Rules And Regulations

To print our Rules and Regulations page for your own records, please click this link. By checking this box you attest that you have read and agree to LOPCI's Rules and Regulations Form.

Signature (Signee acknowledges the Rules and Regulations Form has been read and agreed upon. Signee must be at least 18 years of age)*

Client Agreement Form*

I agree to LOPCI's Client Agreement Form

Client Agreement Form*

I have read and agree to LOPCI's Client Agreement

To print our Client Agreement Form for your own records, please click this link. By checking this box you attest that you have read and agree to LOPCI's Client Agreement.

Signature (Signee acknowledges the Client Agreement Form has been read and agreed upon, Signee must be at least 18 years of age)*

Waiver and Release of Liability*

I agree to LOPCI's Waiver and Release Form

Waiver And Release Form*

I have read and agree to LOPCI's Waiver and Release Form

To print our Client Agreement Form for your own records, please click this link. By checking this box you attest that you have read and agree to LOPCI's Client Agreement.

Signature (Signee acknowledges that the Waiver and Release of Liability Form has been read and agreed upon, Signee must be at least 18 years of age)*

Signature (Signee acknowledges all forms have been read and agreed upon, Signee be at least 18 years of age)*

Upload vaccination records below:

Drop files here or

Max. file size: 64 MB, Max. files: 10.

Upload your dog's picture below:

Drop files here or

Max. file size: 64 MB, Max. files: 10.

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