Membership Application (1 Dog)

Name *
Address *
Phone *
Gender *
Birthdate (Owner) *
Birthdate (Owner)
Dog's Sex *
Dog's Birthday
Dog's Birthday
Is the dog spayed/neutered?
Is this dog currently vaccinated against Rabies, DHLPP (Distemper) and Bordetella (Kennel Cough)? *
Is this dog on monthly heartworm prevention? *
Has this dog been properly socialized for group play? *
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. *