Dog Boarding application form Complete this form to apply for Dog Boarding accommodation at Nelson Bay Kennels. Pet Owners Name* First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Phone*Mobile Phone*Email Address* Date In*Check in Day Date Format: DD slash MM slash YYYY Date Out*Day of Check Out Date Format: DD slash MM slash YYYY Your Pet's Name* Your Pet's Breed*Is your Pet de-sexed?*YesNoWho is your Pet's Vet?*Your Pet's vaccination details - minimum C5 is required*Photos*From time to time we like to publish photos of our boarding Dogs and other pets on Social Media. Please indicate whether you approve of this. We assume you do unless otherwise indicated.ApproveDisapproveI understand that Nelson Bay Dog Boarding Kennels are not Veterinarians and, in the event of a suspected illness the proprietors, or their staff, can at my expense call a Veterinarian to attend to my Pet.If the Pet is not picked up within one month I understand that Nelson Bay Dog Boarding Kennels will have the right to attend to the matter as they see fit.I understand that it is an offence to abandon and animal, and that Nelson Bay Dog Boarding Kennels will notify the proper authorities if they feel this is the case. This shal not release me from liability for an unpaid fees or charges due.I warrant the animal is in fit and sound condition, free of lice and has been immunised against Feline Enteritis and has been recently treated for Fleas and Ticks by Frontline, or a suitable equivalent, and agree that if my Pet is in the Kennels for more than two weeks, that regular Flea, Tick and Worming traetments may be applied at my expense.I acknowledge that payments are appreciated in advance. All fees and charges are to be paid in full by me before removal of the animal.Agreement*By submitting this form you acknowledge that you have read, and accept, our Dog Boarding Terms, and you agree to the above conditions. Agreed NameThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.