Intake Form – Rain Coast Dogs

Dog's Name

Birth/Gotcha date

estimated birthdate acceptable, must be same as with your vet.

Sex *

Female intact
Female spayed
Male intact
Male neutered

Breed

Place "X" between mixed breeds, or "?" if they're a mystery mutt!

Microchip/Tattoo #

If none, leave blank.

License tag #

if not registered with your town/SCRD, leave blank.

Owner Name *

First

Last

Email *

Pickup/Drop-off Address

Phone number *

Secondary contact

First

Last

Secondary number

Emergency contact *

First

Last

Option for a relative, friend, etc. to be contacted only if primary and secondary numbers are unsuccessful, in case of emergency ONLY.

Emergency contact number *

Veterinary Clinic

Address

Veterinarian number *

Vaccinations up-to-date?

Flea/Tick medication

name & last dosage.

Socialization (with dogs)

Select all that apply.

Will your dog react to certain people, situations, or places? Please describe (leash tangles, children, other dog breeds, the vet, being in a car, having their paws touched, etc.)

Does your dog show signs of possession/aggression in the presence of:

Food
Balls
Sticks
Other*

Select all that apply.

* if you selected Other, please explain below:

If More, please explain below:

On our hikes, is your dog

On leash only
Off leash allowed
In training for off leash (long-line training)

Does your dog have Allergies?

Yes*
No

*If yes, describe below:

Please list any health issues past/present/current we should be aware of:

Please describe any other concerns, habits, temperaments, or considerations not addressed above? Instances of reactivity, seemingly ridiculous fears, odd behaviours you find kinda charming etc. This is very important so I can get to know your dog better and best predict how they will react on hikes:

Rain Coast Dogs acknowledges that we are a settler run business operating on the traditional, unceded territories of the Sḵwx̱wú7mesh (Squamish) and Shíshálh (Sechelt) Nations. In an effort to do our part in terms of reparations, we offer a reconciliation discount to clients of indigenous descent. It is important to us that we offer this, but recognize that it is not our place to decide who gets it and who doesn't. If you are a self-identified indigenous person and wish to accept a reparations discount, check the box below, no questions asked. We are more than happy to discuss our decision to offer this further, but by no means should you feel obligated to talk about it.

I identify as Indigenous, and accept a reparations/reconciliation discount for the services offered by Rain Coast Dogs.

TERMS & CONDITIONS: • Your dog must have basic obedience (sit, stay, come) and strong recall to qualify for off-leash privilege. • Your dog must remain current with vaccinations. • Your dog must have Registration tags while out in the SCRD. Any and all liability that comes from a dog not being tagged (tickets incurred, for example) will be the sole responsibility of the owner to rectify. Please ensure your dogs tags are well secured to your dog’s collar/harness at all times. • Your dog must be non-aggressive, and well socialized with other dogs and people to qualify for off-leash privilege. • Owners provide collars, harnesses, leads (& coats if necessary). Rain Coast Dogs is not responsible for replacement of damaged or lost collars, leashes, coats, registration tags or name tags that may go missing or get damaged during walks. • Rain Coast Dogs will supply treats and compostable waste bags. • Rain Coast Dogs may deem any dog/client unfit for off leash services at their discretion. FREE CONSULTATION MEETING Rain Coast Dogs offers a free half-hour, no obligation consultation to determine if the dog can respond to basic commands, share questions and information on client needs and Our practices to determine if we are a fit. At the time of consultation it is encouraged to be prepared with questions, or concerns you may have as a dog owner and client. Your completed consultation request and client form is requested by Rain Coast Dogs to allow for increased time to interact with you & your dog. The consultation helps to ensure your dog receives the best possible care. HOME SECURITY & DATA PROTECTION: Rain Coast Dogs will keep all keys, remote control entry devices, access codes and personal information of the owner(s) secure and in safe keeping and never attached to your address. Rain Coast Dogs will also return all of the above at the end of the contract or immediately upon request. COMMUNICATIONS: Rain Coast Dogs provides walk updates via Instagram & Facebook, but upon request we can provide a courtesy text message update upon returning your dog home safely. If you would NOT like Rain Coast Dogs to use your dog's photo in social media updates, please refer to the "Social Media waiver" below. Otherwise, follow us and we’ll tag you in our posts! CANCELLATIONS: 24 hour notice is required to cancel a scheduled walk. If Rain Coast Dogs has been scheduled for a walk and arrives to a home without a dog present you will be charged in full for that day’s walk. If unforeseen circumstances arise (outside of extreme weather conditions) where Rain Coast Dogs would have to cancel a walk, Rain Coast Dogs will reschedule that walk and at no charge. TERMINATION OF SERVICE: Service will end when either party gives 7 (seven) days written notice of termination. And after services have been paid in full. INCLEMENT WEATHER: Walks take place rain, shine or snow (dangerous weather excluded). General west coast conditions won’t stop us, but wind storms, heat waves etc can pose safety risks. RETURNING DIRTY DOGS: Due to the nature of off leash dog walking on trails and near lakes, streams, and ocean, dogs can get dirty. After a walk dogs can be wet, dusty, even muddy, so please be prepared to identify returning entrances during consultation. If your dog doesn't have a designated area, or crating area, please leave a towel near the returning door/mud-room and Rain Coast Dogs will do their best to wipe down your dog upon drop-off. Please note: Rain Coast Dogs is not a grooming service, so your dog will likely require further cleaning in certain seasons. We will do our best to keep your dog from bringing the forest/beach home with them, within reason. SAFETY Rain Coast Dogs takes the safety of dog clients seriously. If your dog is deemed undisciplined, aggressive, or unresponsive the dog will not be accommodated by our services. If your dog does not exhibit these traits during the consultation, but they arise at a later date, Rain Coast Dogs withholds the option to terminate service immediately. FLEAS & TICKS: Ticks and fleas aren't foreign to dogs, particularly off leash in warmer months. Rain Coast Dogs recommends you check your dog regularly for both and requests that you make alternate arrangements to scheduled walks if your dog is being treated so as to avoid spreading to other dogs in the group. EMERGENCY PROCEDURE: Rain Coast Dogs carries a phone for emergencies. If your dog is lost or hurt the protocol is as follows: a) Contact primary, secondary, or emergency contact on client consultation sheet in that order. b) Return to the vehicle with other dogs, or if unavailable, leash other dogs. c) Attempt to locate the missing dog, or if injured, administer First Aid and/or transport the dog to the nearest Veterinarian. WAIVER: I have read, understand, and acknowledged Rain Coast Dogs's terms and conditions and waiver by submitting the above form. By reading, understanding, and acknowledging the terms and conditions and waiver and proceeding into an agreement and schedule of care with Rain Coast Dogs I affirm that I understand the inherent risks and hazards associated with the nature of off leash dog walking and Rain Coast Dogs's services. These risks also include, but are not limited to risks associated with picking up my dog, dropping off my dog, traveling to and from my home in a vehicle, having my dog around other dogs, people, wildlife, and outdoor environments. Rain Coast Dogs will take reasonable action to minimize these risks, but I understand it is not always possible to prevent injuries that may occur during off leash walks in outdoor environments. I, as the dog owner, am fully responsible for the actions of my dog if it causes any damage whatsoever, including, but not limited to, death, damage or injury to itself, or death, damage or injury to other animals, pets, people and property while in the care of Rain Coast Dogs. I affirm that I have provided all necessary information to Rain Coast Dogs and through consultation deem that my dog is suitable to be in the care of Rain Coast Dogs. I also affirm that I have not witnessed my dog display aggressive tendencies towards people or other animals in the past, or if so, have identified this in my submitted client contact form and/or during consultation. My dog is obedient and capable of following commands, is well behaved and has reliable recall even in distracting environments or is designated as On-leash only. I agree to immediately advise Rain Coast Dogs of any new problems with my dog that could affect his/her behavior, health, or suitability for off leash group walks. In the event of any illness or injury to my dog while in the care of Rain Coast Dogs, I authorize Rain Coast Dogs to take my dog to the nearest veterinarian and agree to pay for all veterinary care required in the opinion of the veterinarian up to the amount of up to $500.00 (if different amount, please fill in the "Emergent Care Cost" form below) in the event the emergency contact is unavailable. I agree to indemnify and hold harmless Rain Coast Dogs and the SCRD, Town of Gibsons, & District of Sechelt against loss or threatened loss or expense by reason of the liability or potential liability of my dog for or arising out of any claims for damages. This includes, but is not limited to, medical attention to people, emergency or veterinary care (including acts of nature, encounters with wild animals, etc.), any damages caused by acts of aggression (biting, attacks, etc.), or any injury caused by my dog toward property, animals and people while in the care of Rain Coast Dogs. Additionally, any costs associated with the above actions will be wholly reimbursed to Rain Coast Dogs if applicable. I affirm that my dog is spayed or neutered and up to date with the following vaccinations: Rabies, Distemper, Parvovirus, Bordetella, and Leptospirosis. I understand that regular vaccinations cannot completely guard against illness and disease, and that Rain Coast Dogs cannot prevent, nor be responsible for any illness my dog might contract. Rain Coast Dogs shall not be liable for any illness or ailment which a dog may incur while in the presence of other dogs in Rain Coast Dogs's care. I hereby waive and release Rain Coast Dogs and the SCRD from any and all claims, actions, suits, demands, assessments or judgments asserted and any and all losses, liabilities, damages, costs and expenses (including, without limitation, attorneys fees and accounting fees to the extent permitted by law) alleged or incurred arising out of or relating to any operations. My submission of the above consultation form confirms that I have completely read, understand and acknowledged Rain Coast Dogs's waiver, the Rain Coast Dogs terms and conditions, and completed the Rain Coast Dogs client information form and understand and agree to all of the terms outlined. *

Agreed
Do not Agree

This waiver will be printed and brought to your home for you to sign in person. Agreeing to the terms above on this form is an agreement of the terms in their entirety. Hard copy signature will be used in the case of an insurance claim only.

Social Media Waiver

Emergent Care cost

If different from $500.00, please fill in above, otherwise, leave blank.