Office Use Only Booking ID: _____________________ Deposit Paid: $__________________ Amount Owing: $________________ Suite Number: __________________ Documents Uploaded: ☐

Tango’s Cat Boarding – Booking Form – New Guest/s

Boarding from:	Boarding to: (select date)

Number of nights:	Number of cats boarding:

Would you like your cats to share suites?	☐ Yes	☐ No ☐ N/A

Type of Suite

☐ Weekender (max 3 nights)	☐ Standard Suite	☐ Executive Suite

Your Details

Full Name:

Address:

Email Address:

Mobile Number:

Contact details for when you are away:

Alternate Mobile Number

Emergency Contact Name:

Emergency Contact Number:

Cat’s Current Veterinary Clinic:

Veterinary Clinic Phone Number:

☐ I give permission for RSPCA ACT to request my cat’s veterinary history at time of this booking

Should I or my emergency contact be unreachable, I authorise:

☐ RSPCA ACT in an emergency situation to provide necessary treatment to the value of $500

☐ RSPCA ACT in a non-emergency situation to provide necessary treatment to the value of $250

☐ RSPCA ACT in a non-emergency situation, to transfer my cat to the veterinary clinic listed above to which I have attached a copy of my treatment agreement (as per terms and conditions)

☐ I would like to receive photos of my cat(s) to the above Select ($2 per day)

☐ I confirm that all information above is correct and I understand the terms and conditions

Payment

I would like to pay by: ☐ Over the phone ☐ Mastercard	☐ VISA

Name on Card:

Card Number:

Expiry:	CVV

Cat Details (if more than one cat, please use additional form found on page 3)

Name:	Age/DOB:	Gender: Select

Breed:	Colour:

Microchip Number:	Vaccination Certificate Attached? Select

Please provide details of any health problems, including any food or medication requirements:

Please provide details of any behaviour requirements (ie is your cat shy, nervous or don’t like handling?)

What is their favourite toy?

Do they enjoy being groomed?

What makes them happy?

What makes them unhappy?

If they are feeling a bit stressed, is it normal for them to: (tick all that apply)

☐ Not eat or toilet	☐ Sneeze	☐ Have a weepy eye(s)	☐ Toilet inappropriately

☐ Vomit	☐ Diarrhoea	☐ Growl/Strike or Bite	☐ Hide

Is there anything else we need to know about your cat?

I found out about Tango’s Cat Boarding: (please select one)

☐ At time of Adoption	☐ Internet Search	☐ Facebook	☐ Instagram

☐ Recommendation	☐ RSPCA Newsletter ☐ Other:

☐ I give permission for my cat/cats image to be used in RSPCA ACT publications and website

☐ I would like to be added to the RSPCA ACT mailing list

Please email completed form, along with vaccination certificate/s and veterinary treatment agreement (if not utilising RSPCA veterinary services) to:

pac@rspca-act.org.au

Cat Details

Name:	Age/DOB:	Gender: Select

Breed:	Colour:

Microchip Number:	Vaccination Certificate Attached? Select

Please provide details of any health problems, including any food or medication requirements:

Please provide details of any behaviour requirements (ie is your cat shy, nervous or don’t like handling?)

What is their favourite toy?

Do they enjoy being groomed?

What makes them happy?

What makes them unhappy?

If they are feeling a bit stressed, is it normal for them to: (tick all that apply)

☐ Not eat or toilet	☐ Sneeze	☐ Have a weepy eye(s)	☐ Toilet inappropriately

☐ Vomit	☐ Diarrhoea	☐ Growl/Strike or Bite	☐ Hide

Is there anything else we need to know about your cat?