Canine Playgroup Form Skip to Main Content Skip to Footer
CAREERS | Kennels (765) 463-1603
Hours 3662 North 250 West
West Lafayette, IN 47906
(765) 463-2611

Canine Playgroup Form

Household Information

Adult Name:

Adult Name:

Adult Name:

Child Name & Age:

Child Name & Age:

Child Name & Age:

Child Name & Age:

Pet Information

Patient Name and Breed:

Pet 2 Name and Breed:

Pet 3 Name and Breed:

Pet 4 Name and Breed:

Pet 5 Name and Breed:

Patient Sex, Spay/Neuter, Age, Adoption Order:

Pet 2 Sex, Spay/Neuter, Age, Adoption Order:

Pet 3 Sex, Spay/Neuter, Age, Adoption Order:

Pet 4 Sex, Spay/Neuter, Age, Adoption Order:

Pet 5 Sex, Spay/Neuter, Age, Adoption Order:

Veterinarian/Clinic Name:

Phone Number:

Emergency Contact Information

Contact Name:

Relationship:

Phone Number:

 

Daily

Twice a week

Seldom to Never

Jogs with person

Outdoors, unsupervised

Leash walks

Dog Park

Swimming

Access to Fenced Backyard

Goals

1.

2.

3.

1.

2.

3.

RULES AND REGULATIONS: Each dog owner must check the box to acknowledge full understanding and agreement to follow each rule.

 

Agree

Alll owners shall watch their dog(s) and keep them within their View and Command at all times.

All dog(s) must be current on the following required vaccinations/tests: Rabies, DHLPP, Bordetella, and an annual negative fecal and heartworm test.

All dogs must wear a basic flat buckle collar with identification tags at all times. Dogs are not permitted to wear choke chains, pinch (prong), spike, electronic shock collars or limited slip collars with chain material.

Dogs must be leashed in parking/entrance areas of the park. When in off-leash areas, all dogs must be off-leash except in the case of an emergency situation or when the owner is directed to leash their dog by KCRSP staff. Each owner agrees to carry a leash for each dog under their supervision at all times while inside the park/playgroup zones.

Retractable leashes are not permitted on the grounds.

No dog(s) may be left unsupervised in the Dog Park/Playgroup zones at any time! If an owner needs to leave the Dog Park/PG zone, their dog(s) must go with them.

The owner must keep their dog(s) near them at all times and clean up and dispose of all of their dog’s waste, including vomit.

Digging is not allowed anywhere in the park. For the safety of all, if a dog digs, its owner must repair the area and notify KCRSP Staff promptly.

Any child under the age of 12 years must be with an adult at all times. Prevent injuries by not allowing children to run or play around the dogs in the off leash areas. A child that is running, crying, or screaming, may seem like prey to a dog—even a normally non-aggressive dog. It cannot be emphasized enough to parents that children must be supervised at all times when interacting with any dog.

All dogs over the age of 7 months must be spayed or neutered to attend Playgroups or use the Dog Park.

Female dogs under 7 months of age are not permitted in the Dog Park or Playgroups when in season (during a heat cycle).

Dogs under 4 months of age are not permitted in the Park or Playgroup areas unless they are currently enrolled in the Klondike Canine Academy Puppy Pre-school class.

If any aggressive behavior (i.e. growling, posturing, nipping, resource guarding, etc.) is shown by any dog(s), its owner shall immediately stop the behavior, which may include leashing their dog and leaving the area or moving to another area away from any other dogs, to effectively prevent the aggressive behavior from recurring.

All dogs must be accompanied in the Park / Playgroups areas at all times by an authorized family member 18 years or older.

By signature below and/or initials above, I agree that I have read, understand and agree to abide by each and every of the Contract Regulations and all Rules and Regulations and fully understand the Release and Waiver of Liability and Assumption of Risk agreement. Failure to comply with all rules may result in revocation of park visitation or membership privileges. I further understand that KCRSP reserves the right to alter or amend its rules at any time with reasonable notification.

PLAYGROUP / DAYCARE AGREEMENT:

The undersigned hereby requests that their dog be allowed to attend Playgroups or Daycare conducted by Klondike Canine Academy at Klondike Kennels and/or Klondike Canine Recreation and Sports Park abbreviated as KCRSP. Prior to entry to the Canine Playgroups or Daycare the undersigned shall disclose to staff all information about their dog(s) temperament, including any incident of aggression. Any change in temperament or incident occurrence shall be disclosed in writing to KCRSP staff prior to future visits. It is understood and agreed that the undersigned and the undersigned’s dog will be assessed by the staff for compatibility and compliance with Playgroup/Daycare interest, with Klondike Canine Academy staff reserving the right to terminate this agreement based on such assessment. KCRSP reserves the right to request a recheck canine behavior assessment at our discretion at any time during active or inactive membership in determining continued compatibility with Playgroup/Daycare interest and owner agrees to pay any fees incurred for such assessment. KCRSP reserves the right to deny the undersigned entry or membership to the Playgroups for any reason, and to terminate membership or expel the undersigned, any family member or guest of the undersigned and/or dog(s) from the facility for any reason including failure to follow any or all park rules. In the event this agreement is terminated a prorated refund of Playgroup Pass fees will be made. The canine behavior assessment fee is non-refundable. This Playgroup/Daycare Registration is non-transferable.

RELEASE AND WAIVER OF LIABILTY AND ASSUMPTION OF RISK: Read carefully to insure full understanding before accepting.

The undersigned understands that attendance at Playgroups/Daycare means that the undersigned is taking certain risks of damage or injury or exposure to health risks, including infectious disease to the undersigned, the undersigned’s family members, the undersigned’s guest(s), the undersigned’s dog, the undersigned’s property and to others in the Playgroups/Daycare. The undersigned realizes that when dogs and people are together in a confined area, some accident, injury or sickness may result, and that people, children, dogs and property might be injured or damaged.

Because the undersigned wants to attend Playgroup/Daycare with his/her dog, the undersigned hereby agrees to assume any and all risks, whether known or unknown and assumes full responsibility for any injury to the undersigned, the undersigned’s family members, the undersigned’s guest(s), the undersigned’s dog, and damage to the undersigned’s property. The undersigned agrees that he/she has inspected Klondike Kennels and KCRSP property, and will continue to stay vigilant regarding the property and regarding the undersigned’s family members, the undersigned’s guest(s), the undersigned’s property, and the undersigned’s dog(s). The undersigned expressly agrees that it is solely his/her responsibility to determine on each visit to Klondike Kennels and KCRSP property itself and any particular situation involving other members, guests and dogs are safe for the undersigned, the undersigned’s guest(s), the undersigned’s children, the undersigned’s property, and the undersigned’s dog. In exchange for the opportunity to attend Playgroups/Daycare, the undersigned hereby releases and discharges Blair Animal Clinic, P.C., Klondike Kennels, Inc., Klondike Canine Academy and KCRSP and their officers and employees, directors, property landlord or appointees or representative from any and all liability, claims, demands, causes of action, loss, damage, injury or illness to the undersigned, the undersigned’s family members, the undersigned’s guest(s), the undersigned’s dog, and the undersigned’s property, including any death and/or serious injury which may result while the undersigned or the undersigned’s family members, the undersigned’s guest(s) and the undersigned’s dog are on the Klondike Kennels and KCRSP premises. The undersigned also agrees to be responsible for the conduct of the undersigned’s family members, the undersigned’s guests and the undersigned’s dog, whether intentional or negligent, and for any injury or damage to others caused by the undersigned, the undersigned’s family members, the undersigned’s guest(s), and the undersigned’s dog and the undersigned will hold harmless and indemnify Blair Animal Clinic, P.C., Klondike Kennels, Inc., Klondike Canine Academy and KCRSP and their officers, directors, employees and property landlord or appointees or representative from any and all liability, claims, demands, causes of action, loss, including attorney fees, arising from damage or injury to person or property, including any death and serious injury which may be caused by the undersigned, the undersigned’s guests, or the undersigned’s dog while they are on the KCRSP Premises. The undersigned swears or affirms that they are 18 years old or older and have the legal capacity to enter into a binding contract. The undersigned intends for this release to be binding upon his/her heirs, beneficiaries, next of kin, personal representative or executor, and assignees.

Addendum:
o All playgroup passes will expire 1 (one) month from date of purchase.
o Every dog must attend at least 1 (one) playgroup/daycare session every 3 (three) months to maintain an active playgroup membership.

INDEMNIFICATION AND HOLD HARMLESS AGREEMENT

I, the undersigned, in consideration of my request for a Canine Behavior Assessment which will be conducted at Klondike Kennels, Klondike Canine Academy, and/or Klondike Canine Recreation and Sports Park abbreviated as KCRSP, do hereby agree to indemnify and hold harmless Blair Animal Clinic, PC and Klondike Kennels, Inc., their officers, agents and employees, volunteers and students, from and against any losses, costs, damages and expenses, including attorney’s fees, arising out of or resulting from claims or suits, by or on behalf of any person, for any injury caused by my dog being assessed to any person now or in the future, including my family members and any guest invited by me who is permitted to attend such assessment, and/or for any injury to , dogs or any other animals dog will have contact with now or in the future, of whatever cause or nature, arising out of said assessment, the results of said assessment and related activities whether or not such injuries are caused in whole or in part by negligence or other fault of Blair Animal Clinic, PC and Klondike Kennels, Inc., their officers, agents and employees, volunteers and students.

I, the undersigned, understand that behavior of this dog can change from the time of the assessment for any number of reasons beyond the knowledge and control of the individual or individuals doing the assessment and the undersigned is expressly agreeing to indemnify and hold harmless Blair Animal Clinic, PC and Klondike Kennels, Inc., their officers, agents and employees, volunteers and students from any losses, costs, damages and expenses, including attorney fees, arising out of or resulting from claims or suits, by or on behalf of any person, for any injury caused by this dog in the future to persons, animals and/or property.

I, the undersigned, represent that I am at least eighteen (18) years of age, understand the obligations I am undertaking by this Agreement and am executing this Agreement freely and voluntarily.

Blair Animal Clinic