Enrollment Forms Page 3
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Pick-Up Permission List
Name: _________________________ Relation to dog(s): ______________________
Phone: _________________________ Email: _________________________________
Name: _________________________ Relation to dog(s): ______________________
Phone: _________________________ Email: _________________________________
Name: _________________________ Relation to dog(s): ______________________
Phone: _________________________ Email: _________________________________
Name: _________________________ Relation to dog(s): ______________________
Phone: _________________________ Email: _________________________________
| | I acknowledge that by listing this/these person(s) as authorized to pick up I am
relieving Dogtopia of all liabilities in giving this person my dog(s).
Signature: ______________________________________________________
Date: __________________________________
Dogtopia
daycare • boarding • spa
Independently owned and operated
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Parent category: Medical