Membership Registration Form

Are there 5 or more dogs in your pack?

YesNo

Before filling out this form, please contact us at wag@barkdogbar.com to discuss your Membership.
We look forward to seeing you and your pack at Bar K!

Do you regularly foster, board or dog-sit?

YesNo

We love the fact that you love dogs enough to foster, dog-sit or board, and we want to encourage that and help as much as possible.

We know that you might want to bring some of these dogs to Bar K, and we want to support that as well, without having to charge a guest fee every time. At the same time, we also want to make sure we maintain a safe environment for all our guests. So, we have designed a special membership package that might work for you.

You can now buy a Bar K Foster/Dog-Sitter Membership Package for an annual fee of $300. This will allow you to bring all dogs under your care and custody to Bar K, including your own dogs as well as dogs that you are fostering, dog-sitting or boarding.

We will require that you certify that all of the dogs that you bring into Bar K are current on all required vaccinations (Rabies, DHLPP and Bordetella), and that all dogs are properly socialized for group play. We will also have a maximum limit of four (4) dogs per visit.

If you would like to purchase a Foster Membership, please fill out the following form for you and all your own dogs (not your foster dogs). When you get to the pay screen, choose "Foster/Sitter Membership."

Name*

First NameLast Name

Address:*

Street Address

Street Address Line 2

CityState

Zip Code

E-mail*

Phone Number:*

Gender (owner)*

M- MaleF- FemaleN - N/A

Date of Birth (owner)*

MonthDayYear

Significant Other

First NameLast Name

Dog's Name*

Dog's Breed*

Dog's Sex*

MF

Dog's Birthday (example: 01-11-2014)

MonthDayYear

Next, please provide us some info on your dog(s)

Is this dog spayed/neutered?

YesNo

Is this dog currently vaccinated against Rabies, DHLPP (Distemper) and Bordetella (Kennel Cough)? *

YesNo

Is this dog on monthly heartworm prevention? *

YesNo

Has this dog been properly socialized for group play?*

YesNo

Who is your vet?*

If your vet isn't listed above, please select "Other" and provide us your dog's Veternarian information below:

Other:

Anything else we should know about your pup?

Do you have more than one dog?*

YesNo

Dog 2 Name*

Dog 2 Breed*

Dog 2 Sex*

M - MaleF - Female

Dog 2 Birthday

MonthDayYear

Is this dog spayed/neutered?

YesNo

Is this dog currently vaccinated against Rabies, DHLPP (Distemper) and Bordetella (Kennel Cough)?*

YesNo

Is this dog on monthly heartworm prevention? *

YesNo

Has this dog been properly socialized for group play?*

YesNo

Anything else we should know about this dog?

Do you have more than two dogs?

YesNo

Dog 3 Name*

Dog 3 Breed*

Dog 3 Sex

M - MaleF - Female

Dog 3 Birthday

MonthDayYear

Is this dog spayed/neutered?

YesNo

Is this dog on monthly heartworm prevention? *

YesNo

Is this dog currently vaccinated against Rabies, DHLPP (Distemper) and Bordetella (Kennel Cough)?*

YesNo

Has this dog been properly socialized for group play?*

YesNo

Anything else we should know about this dog?

Do you have more than three dogs?

YesNo

Dog 4 Name*

Dog 4 Breed*

Dog 4 Sex

M - MaleF - Female

Dog 4 Birthday

MonthDayYear

Is this dog spayed/neutered?

YesNo

Is this dog on monthly heartworm prevention? *

YesNo

Is this dog currently vaccinated against Rabies, DHLPP (Distemper) and Bordetella (Kennel Cough)?*

YesNo

Has this dog been properly socialized for group play?*

YesNo

Anything else we should know about this dog?

I understand that off-leash dog play is potentially dangerous and involves inherent risks, including but not limited to bites, scratches, jumping, collisions and other injury or harm to me, my dependents/family members and/or our dog(s). By entering Bar K, we knowingly and voluntarily accept these risks, and release and hold harmless Bar K, Bear Bishop LLC, PortKC and their partners and joint venturers from any claims or liabilities of any kind arising out of these risks while utilizing this facility. *

I understand

By signing, I am confirming that all of the information I have entered is true and accurate*

Clear

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Enter coupon