(* indicates a required field)

Pet Information

1st Pet 2nd Pet 3rd Pet
Name * Name * Name *
Breed Breed Breed
Color Color Color
DOB or Age DOB or Age DOB or Age
Gender


Gender Gender
Weight Weight Weight

Neutered or Spayed?

Neutered or Spayed?
Neutered or Spayed?
List any preexisting conditions, behavior problems, or special needs for your pet(s):

Food Schedule

Food Type

Food Type

Food Type

Quantity Quantity Quantity
Time

(Choose all that apply)
Time

(Choose all that apply)
Morning
Afternoon
Evening
Time

(Choose all that apply)
Morning
Afternoon
Evening
Special Instructions Special Instructions Special Instructions

Medication Schedule

Medication

Medication

Medication

Quantity Quantity Quantity
Time

(Choose all that apply)
Time

(Choose all that apply)
Morning
Afternoon
Evening
Time

(Choose all that apply)
Morning
Afternoon
Evening
Special Instructions Special Instructions Special Instructions

Owner Information

First Name * Last Name *
Address Home Phone
City Work Phone
State Cell Phone
Zip Email Address *

Boarding Information

Arrival Date Arrival Time


Departure Date Departure Time


Referred by Type of Boarding Requested
Additional Activities Requested (Choose all that apply)
1st Pet 2nd Pet 3rd Pet

(Choose 10 Activities below - 5 river walks = 5 activities)
OR
(Choose 6 Activities below)


(Choose 10
Activities below - 5 river walks = 5 activities)
OR
(Choose 6 Activities below)
(Choose 10 Activities below - 5 river walks = 5 activities)
OR
(Choose 6 Activities below)
(** Activities included in all camp packages)
Activity
QTY
Activity
QTY
Activity
QTY
River Walk
River Walk
River Walk
Garden Walk
Garden Walk
Garden Walk
Frisbee Fields
Frisbee Fields
Frisbee Fields
Agility Playground
Agility Playground
Agility Playground
Extra Cuddle Time**
Extra Cuddle Time**
Extra Cuddle Time**
Board & Train
Board & Train
Board & Train
Bird Watching on the Vermillion
Bird Watching on the
Vermillion
Bird Watching on the Vermillion
Campfire Weenie Roast**
Campfire Weenie Roast**
Campfire Weenie Roast**
Diving for Weenies
Diving for Weenies
Diving for Weenies
24 Photos**
24 Photos**
24 Photos**
Grooming (Choose all that apply)
1st Pet 2nd Pet 3rd Pet
Bath & Towel Dry
Nails
Condition & Blow Dry (Long Coat)
Coat Conditioner
Bath & Towel Dry
Nails
Condition & Blow Dry (Long Coat)
Coat Conditioner
Bath & Towel Dry
Nails
Condition & Blow Dry (Long Coat)
Coat Conditioner
Veterinarian * Vet Phone *
Vet Address Vet Fax
Vaccination Records

All pets' vaccinations (rabies, distemper parvo, and bordetella) are current now.
All pets' vaccinations will be current before arriving at Starved Rock Pet Resort.

MUST PROVIDE PROOF. Ask your vet to fax records to us at (815) 673-1222

Owner Location during Pet Stay Owner Contact Number during Pet Stay

Important Note: Your reservation is not confirmed until you receive an email or phone confirmation for the specific dates you have requested.

 
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