Crisis support

Owner First Name *

Owner Surname *

Street Address *

City *

State *

Post Code *

Phone Number *

Email Address (non NT Gov or NT Schools email addresses please)(Please check spam folder as you will get an automatic email once you submit this form and future emails may also go there) *

Facebook Profile

Animal Name *

Species *

Gender *

Breed *

Date of Birth *

Size *

Colour *

Is your pet Desexed *

Is your animal up to date on vaccinations *

Does your animal have any known health issues/medication which we need to be aware of? *

If yes above please supply details?

Does your animal have any known behavioural issues we need to know about? *

If yes above please supply details?

Emergency Contact Name *

Emergency contact number *

Vet Clinic Address *

Vet Clinic Contact Number *

Vet Clinic Name *

Drop off Date *

Please state the reason you are applying for Crisis care, please note that we are not wanting every detail of your life, just enough information to determine if your need is genuine as we have limited places. *

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Owner will provide vaccination records from your vet before boarding date

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Owner agrees to pay the total amount agreed to on the due dates,

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If the pet shall in any form become ill or if the state of the animals health requires attention Paws Darwin at its sole discretion are authorised to engage the service of the Veterinarian provided in this Pet Boarding Contract. If listed Veterinarian is unavailable Paws Darwin has the right to provide in house veterinary services or arrange alternate for the animal up to $5000 at owners expense.

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Owner will be held solely responsible for any and all acts or behaviour including aggression that takes place during boarding and any resultant expenses

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Owner specifically represents that they lawfully own pets listed in this Agreement

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Owner understands that the pet shall not leave the kennel until all fees and charges are paid in full. Daily fees continue to accrue until this time.

Vaccinations: - Every pet must have a current vaccination prior to checking-in. Pets that have not been vaccinated for more than 12 months must be vaccinated no less than ten (10) days before checking-in. If your pet is due for their updated vaccination, we are happy to arrange the vaccination for you. It is the Owner’s responsibility to ensure that current records have been received prior to your arrival date. Refusal often offends. Required vaccinations are as follow: - Dogs Require: - C5 Vaccination. This vaccination covers Distemper, Hepatitis, Parvovirus, Para influenza and Boardatella bronchiseptia. Note: Dogs that receive the new 3 yearly vaccination must still have a yearly canine cough vaccination. - Cats Require: - F3 Vaccination. This vaccination covers Feline Enteritis and Cat Flu, Should your animal not be vaccinated you will be required to cover costs for vaccination at the shelter clinic, this must be arranged before the animal is left in the care of PAWS Darwin *

Flea, Tick and Worm Treatments: - All pets must have had recent flea and worm treatment not more than 1 month prior to check in as per the Victorian Code of Practice for Boarding Kennels and Catteries. Any dogs coming into the kennel that are found to have fleas or worms will receive immediate treatment at the cost of the owner. Tick treatment must be up to date for pets arriving from regions susceptible to ticks.

Date from which care needs to start *

should you not follow up on all your commitments your pet will be made available for adoption, 8 days from pick up date unless you make new arrangements. You agree that if this occurs PAWS Darwin has permission to act in the animals best welfare by finding them a permanent home. *

Owner agrees to Pet being able to go on walks and other outings with volunteers where suitable especially for dogs. *

Pick Up Date *

Owner agrees to pet going into foster if a suitable foster is found so that the pet does not need to be in kennels for extended periods of time, *

Owner agrees where required to desexing pet under the PAWS Darwin low cost desexing clinic.

Signature of Applicant. Please use your finger on touch screen or click and hold your left button to use your mouse above the line. *

Date *