Important! Only fill in this form if you have been asked to do so by Russell. This is to register your details. All data is kept private and is never used for marketing purposes.
Name:*
Email:*
Telephone (home/mobile):*
Telephone (work):
Emergency Contact:
Emergency Contact Telephone:
Start Date:
End Date:
Service Required (Walk/feed/duration etc):
Add Another Pet
Veterinary Surgeon:
Practice Address:
Telephone Number:
Any recurring health problems:
Where does your pet live?:
Are there any off limit areas?:
Does your pet wear an ID tag?: No Yes
Locaiton of lead/harness:
Is your pet neutered?: No Yes
Can your pet be walked off lead?: No Yes
Has your dog been wormed?: Not Applicable No Yes
Flea treatment up-to-date?: No Yes
By submitting this form you hereby confirm that you understand and agree to the following:-
All invoices must be paid within 10 days of the invoice date. Walks may be terminated if payment is not present.
I am extremely flexible at Rusty's Dog Walking and I understand that circumstances and plans can change. However, a minimum of 24 hours cancellation notice is required except in a case of extreme emergency. Cancellations made with less than 24 hours notice may be charged at their full rate.
Send
I am covered by Pet Plan Sanctuary (Brooks Braithwaite Ltd) Liability Insurance
