Circletop Farm Kennel will be CLOSED
13 Jan 2011 - 22 Jan 2011
We’re sorry for any inconvenience this causes you. 

CIRCLETOP FARM
 KENNEL and/or TRAINING RESERVATION REQUEST FORM

New Client
Returning Client Need only complete your name, email address, phone, pets names, & updates if applicable.

Owner Information:
 
 Required  Your Name
Required  E-mail address:

Phone numbers: ( please include area code )
Required Typing: - area code and phone number with no spaces

Required  Phone

Required Typing: - area code and phone number with no spaces

Required  Emergency phone contact

Work Phone

Cell Phone
Fax Number
Street Address
 Apt/Suite 
City
State    Zip Code
How would you like to be contacted regarding this reservation?
Home Phone Cell Phone Work Phone   E-mail

Other Emergency Contacts:
Names and phone numbers

How did you hear about us:

Arrival Date:       Arrival-Time:

Departure Date:      Departure-Time:

Normal Checkout is before 11:00 a.m. picked up before 11:00 a.m. will not be charged.
Pick up after 11:00 incurs full day's board.
Services Required - Select type of services required: 
Type of Boarding:
  Day Care Boarding
 Type Of Day:
  Full Day Half Day
Board and Train:
  AKC Novice Fetch and Come Housebreaking Walk on a Loose Leash
Group Training:
  AKC Novice Basic Manners Canine Good Citizen
Select a Session:
  Spring Session Summer Session Fall Session
 

Pet Information
How many pets will you be boarding? 
Pet info: date of birth, name. gender, and breed. Please list each pet on a separate line.
PET MEDICAL INFORMATION
Veterinarian Name
Veterinarian Phone No.
Specific Health/Medical Information
Please note any specific health conditions, any required medications, or specific medical information.
Neutered/Spayedy? Yes No
 Required:  Proof of Vaccinations / Bordetella?   Only Answer: Yes or  No  
“Please bring a copy of your shot records to include a bordetella (kennel cough) shot” 
 
OTHER PET INFORMATION:

What is your pet's/pets' eating habits? Brand food? How much and how often?
“Bring enough food for your dog’s stay and an appropriate chew item”

Is your pet/pets afraid of anything such as storms?
Has your pet/pets shown aggression to any people or other animals?

Are there any special commands your pet/pets responds to?

Does your pet/pets prefer to be around men or women?

Any other pertinent information?

Please note that by submitting this request, you are not guaranteed a reservation.
We will contact you to confirm your Pet Reservation.

Required Type (exactly as spelled here) into the box below before submitting or else you will receive an error.

I request and to be contacted by Circle Top Farm.


PLEASE CLICK ONLY ONE TIME TO SUBMIT
 


If you are having any technical difficulty viewing or processing this form, please contact us
 Phone: 270-360-0091 or Cell: 270-272-7698