Junior Vet Clinic Registration Form

"*" indicates required fields

For participants between 3-7 years old, please select a time slot:

1pm – 2pm

2:30pm – 3:30pm

For participants between 8-12 years old, please select a time slot:

4pm – 5pm

5:30pm – 6:30pm

Child's Name*

DOB*

Month

Day

Year

Age*

Parent/Guardian Name*

Phone*

Emergency Contact Name*

Emergency Contact Phone*

Any known allergies? (Example: Latex)*

Yes

If yes, please list all known allergies*

Permission to release photos for social media use:*

Yes

Any additional comments:

Are you interested in being a parent volunteer?*

Yes

Liability Release: Even with the best of planning and precaution, unforeseen events can occur. By signing this form, I agree to assume and accept all risks and hazards inherent in the activities. They also agree not to hold the activity holder or its employees or volunteer assistants liable for damages, losses, or injuries to the person or property undersigned.

Signature*

In order to complete the registration, please ensure you have paid the $10 registration fee (donation to Paisley Paws), which can be paid via the following link:
Paisley Paws Donation

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Name

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