{"id":188,"date":"2019-11-08T04:54:19","date_gmt":"2019-11-08T04:54:19","guid":{"rendered":"http:\/\/eastsidepups.co.nz\/?page_id=188"},"modified":"2025-08-11T09:19:32","modified_gmt":"2025-08-10T21:19:32","slug":"enrolment-form","status":"publish","type":"page","link":"https:\/\/eastsidepups.co.nz\/enrolment-form\/","title":{"rendered":"ENROLMENT FORM"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"188\" class=\"elementor elementor-188\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-1b7cf45 e-flex e-con-boxed e-con e-parent\" data-id=\"1b7cf45\" data-element_type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f02bf8d elementor-widget elementor-widget-heading\" data-id=\"f02bf8d\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">EASTSIDE PUPS DAYCARE ENROLMENT FORM<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bb6660f elementor-widget elementor-widget-text-editor\" data-id=\"bb6660f\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>All cancellations will now incur a cancellation fee depending on the notice given. If your dog can\u2019t attend for any reason, e.g. on holiday, sick, school break, kennels or for any other reason, the following applies:<\/p><ul><li>More than 24 hours\u2019 notice: $25 full day or $15 half day to hold your permanent placement.<\/li><li>Less than 24 hours\u2019 notice: 100% of the daily service fee will be payable.<\/li><li>7 days\u2019 notice is required when you would like to cancel your permanent placement, or the policy above applies.<\/li><li>7days\u2019 notice is required when reducing or changing your permanent daycare day or the policy above applies.<\/li><\/ul><p><br \/>* Exceptions will be made for desexing.<br \/><br \/>All other special circumstances \/ emergencies will be taken into consideration at management\u2019s discretion. Please speak to one of our staff members directly about this. If, for whatever reason, your dog cannot attend their weekly spot, placement can be held for a maximum of 2 weeks or at our discretion and may be terminated by us after that.<br \/>Any dogs that no show or make no contact for 2 weeks will be considered an abandonment and be unenrolled automatically<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-66c7d73 elementor-button-align-center elementor-widget elementor-widget-form\" data-id=\"66c7d73\" data-element_type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" id=\"Enrolment\" name=\"Enrolment Form\" aria-label=\"Enrolment Form\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"188\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"66c7d73\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"EastSidePups\" \/>\n\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_4cee1c0 elementor-col-100\">\n\t\t\t\t\t<h4 class=\"sub\"><b>DOG INFO<\/b><\/h4>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-name elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-name\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tName\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[name]\" id=\"form-field-name\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Name\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-Breed elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-Breed\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tBreed\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[Breed]\" id=\"form-field-Breed\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Breed\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-sex elementor-col-25 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-sex\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tSex\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Male\" id=\"form-field-sex-0\" name=\"form_fields[sex]\" required=\"required\"> <label for=\"form-field-sex-0\">Male<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Female\" id=\"form-field-sex-1\" name=\"form_fields[sex]\" required=\"required\"> <label for=\"form-field-sex-1\">Female<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-date elementor-field-group elementor-column elementor-field-group-dob elementor-col-25\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-dob\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tD.O.B\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[dob]\" id=\"form-field-dob\" class=\"elementor-field elementor-size-sm  elementor-field-textual elementor-date-field elementor-use-native\" placeholder=\"D.O.B\" pattern=\"[0-9]{4}-[0-9]{2}-[0-9]{2}\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-Colour elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-Colour\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tColours \/ Markings\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[Colour]\" id=\"form-field-Colour\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Colours \/ Markings\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_2fc3e7e elementor-col-25\">\n\t\t\t\t\tDog's Photo <br\/>(JPG, PNG and PDF format only)\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-upload elementor-field-group elementor-column elementor-field-group-dogphoto elementor-col-75\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-dogphoto\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tDog's Photo\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input type=\"file\" name=\"form_fields[dogphoto]\" id=\"form-field-dogphoto\" class=\"elementor-field elementor-size-sm  elementor-upload-field\" data-maxsize=\"20\" data-maxsize-message=\"This file exceeds the maximum allowed size.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_89a8a64 elementor-col-100\">\n\t\t\t\t\t<h4 class=\"sub\"><b>VET INFO<\/b><\/h4>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-vet elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-vet\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tName of Veterinarian \/ Clinic\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[vet]\" id=\"form-field-vet\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Name of Veterinarian \/ Clinic\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_437b792 elementor-col-33\">\n\t\t\t\t\tPreferred days of daycare\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-preffday elementor-col-66\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-preffday\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tPreferred days of daycare\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Monday\" id=\"form-field-preffday-0\" name=\"form_fields[preffday][]\"> <label for=\"form-field-preffday-0\">Monday<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Tuesday\" id=\"form-field-preffday-1\" name=\"form_fields[preffday][]\"> <label for=\"form-field-preffday-1\">Tuesday<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Wednesday\" id=\"form-field-preffday-2\" name=\"form_fields[preffday][]\"> <label for=\"form-field-preffday-2\">Wednesday<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Thursday\" id=\"form-field-preffday-3\" name=\"form_fields[preffday][]\"> <label for=\"form-field-preffday-3\">Thursday<\/label><\/span><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"Friday\" id=\"form-field-preffday-4\" name=\"form_fields[preffday][]\"> <label for=\"form-field-preffday-4\">Friday<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_29d697f elementor-col-33\">\n\t\t\t\t\tHas your dog attended a dog daycare in the past?  \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-inthepast elementor-col-33 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-inthepast\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tpast-answer\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-inthepast-0\" name=\"form_fields[inthepast]\" required=\"required\"> <label for=\"form-field-inthepast-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-inthepast-1\" name=\"form_fields[inthepast]\" required=\"required\"> <label for=\"form-field-inthepast-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-pastdaycare elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-pastdaycare\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tIf yes, which one and for how long? \t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[pastdaycare]\" id=\"form-field-pastdaycare\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"If yes, which one and for how long? \">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_9240d97 elementor-col-33\">\n\t\t\t\t\tIs your dog current with all its vaccinations, including Kennel Cough?   \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-Cough elementor-col-66\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-Cough\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tIs your dog current with all its vaccinations, including Kennel Cough-answer\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-Cough-0\" name=\"form_fields[Cough]\"> <label for=\"form-field-Cough-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-Cough-1\" name=\"form_fields[Cough]\"> <label for=\"form-field-Cough-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_305fd5b elementor-col-66\">\n\t\t\t\t\tPlease provide vet certificate or vet booklet What age was your dog desexed? \nPlease attach proof that your dog is up to date with all vaccinations including Lepto and Kennel Cough (Letter from your vet or copy of your Vet book) <br\/>(JPG, PNG and PDF format only)\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-upload elementor-field-group elementor-column elementor-field-group-certificate elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-certificate\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tvet certificate - upload\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input type=\"file\" name=\"form_fields[certificate]\" id=\"form-field-certificate\" class=\"elementor-field elementor-size-sm  elementor-upload-field\" data-maxsize=\"20\" data-maxsize-message=\"This file exceeds the maximum allowed size.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_4c4cf33 elementor-col-33\">\n\t\t\t\t\tIs your dog up to date with Flea and Worming Treatments?  \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-Treatments elementor-col-66 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-Treatments\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tTreatments - Answer\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-Treatments-0\" name=\"form_fields[Treatments]\" required=\"required\"> <label for=\"form-field-Treatments-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-Treatments-1\" name=\"form_fields[Treatments]\" required=\"required\"> <label for=\"form-field-Treatments-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_5bba76d elementor-col-33\">\n\t\t\t\t\tIs your dog desexed?\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-desexed elementor-col-33 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-desexed\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tdesexed - Answer\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-desexed-0\" name=\"form_fields[desexed]\" required=\"required\"> <label for=\"form-field-desexed-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-desexed-1\" name=\"form_fields[desexed]\" required=\"required\"> <label for=\"form-field-desexed-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-date elementor-field-group elementor-column elementor-field-group-whendesexed elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-whendesexed\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tIf yes, when\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\n\t\t<input type=\"date\" name=\"form_fields[whendesexed]\" id=\"form-field-whendesexed\" class=\"elementor-field elementor-size-sm  elementor-field-textual elementor-date-field\" placeholder=\"If yes, when\" pattern=\"[0-9]{4}-[0-9]{2}-[0-9]{2}\">\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_d814fb4 elementor-col-33\">\n\t\t\t\t\tDoes your dog have any allergies to food or environment?\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-field_0a0c3b1 elementor-col-33 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_0a0c3b1\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tallergies - Answer\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-field_0a0c3b1-0\" name=\"form_fields[field_0a0c3b1]\" required=\"required\"> <label for=\"form-field-field_0a0c3b1-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-field_0a0c3b1-1\" name=\"form_fields[field_0a0c3b1]\" required=\"required\"> <label for=\"form-field-field_0a0c3b1-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-field_b63734c elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-field_b63734c\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tIf yes, please explain\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[field_b63734c]\" id=\"form-field-field_b63734c\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"If yes, please explain\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_4443f7b elementor-col-33\">\n\t\t\t\t\tIs your dog on any Medications?  \t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-Medications elementor-col-33 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-Medications\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tMedications - Answer\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-Medications-0\" name=\"form_fields[Medications]\" required=\"required\"> <label for=\"form-field-Medications-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-Medications-1\" name=\"form_fields[Medications]\" required=\"required\"> <label for=\"form-field-Medications-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-explain elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-explain\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tIf yes, please explain\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[explain]\" id=\"form-field-explain\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"If yes, please explain\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_8254f9c elementor-col-33\">\n\t\t\t\t\tIs your dog afraid or nervous about certain sounds\/objects\/people (i.e. children)\/other dogs?\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-afraid elementor-col-33 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-afraid\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tafraid - Answer\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-afraid-0\" name=\"form_fields[afraid]\" required=\"required\"> <label for=\"form-field-afraid-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-afraid-1\" name=\"form_fields[afraid]\" required=\"required\"> <label for=\"form-field-afraid-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-afraidexplain elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-afraidexplain\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tIf yes, please explain\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[afraidexplain]\" id=\"form-field-afraidexplain\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"If yes, please explain\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_88e82cb elementor-col-33\">\n\t\t\t\t\tHas your dog ever displayed any form of aggression? I.e. Growling, biting, fighting etc\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-aggression elementor-col-33 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-aggression\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\taggression - Answer\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  elementor-subgroup-inline\"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-aggression-0\" name=\"form_fields[aggression]\" required=\"required\"> <label for=\"form-field-aggression-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-aggression-1\" name=\"form_fields[aggression]\" required=\"required\"> <label for=\"form-field-aggression-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-explainaggression elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-explainaggression\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tIf yes, please explain\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[explainaggression]\" id=\"form-field-explainaggression\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"If yes, please explain\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-socialisation elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-socialisation\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tHow much socialisation\/contact does your dog get with other dogs?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-eicon-caret-down\" viewBox=\"0 0 571.4 571.4\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M571 393Q571 407 561 418L311 668Q300 679 286 679T261 668L11 418Q0 407 0 393T11 368 36 357H536Q550 357 561 368T571 393Z\"><\/path><\/svg>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[socialisation]\" id=\"form-field-socialisation\" class=\"elementor-field-textual elementor-size-sm\">\n\t\t\t\t\t\t\t\t\t<option value=\"\">How much socialisation\/contact does your dog get with other dogs?<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Rarely\">Rarely<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Sometimes\">Sometimes<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Regularly\">Regularly<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_fd997b2 elementor-col-100\">\n\t\t\t\t\t<h4 class=\"sub\"><b>PERSONAL DETAILS\/EMERGENCY CONTACT<\/b><\/h4>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-Fname elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-Fname\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tFirst Name\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[Fname]\" id=\"form-field-Fname\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"First Name\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-Lname elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-Lname\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tLast Name\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[Lname]\" id=\"form-field-Lname\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Last Name\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-Address elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-Address\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tAddress\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[Address]\" id=\"form-field-Address\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Address\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-Email elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-Email\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tEmail\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[Email]\" id=\"form-field-Email\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Email\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-tel elementor-field-group elementor-column elementor-field-group-hPhone elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-hPhone\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tHome Phone\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input size=\"1\" type=\"tel\" name=\"form_fields[hPhone]\" id=\"form-field-hPhone\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Home Phone\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Only numbers and phone characters (#, -, *, etc) are accepted.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-tel elementor-field-group elementor-column elementor-field-group-wPhone elementor-col-33\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-wPhone\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tWork Phone\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input size=\"1\" type=\"tel\" name=\"form_fields[wPhone]\" id=\"form-field-wPhone\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Work Phone\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Only numbers and phone characters (#, -, *, etc) are accepted.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-tel elementor-field-group elementor-column elementor-field-group-Mobile elementor-col-33 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-Mobile\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tMobile Phone\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input size=\"1\" type=\"tel\" name=\"form_fields[Mobile]\" id=\"form-field-Mobile\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Mobile Phone\" required=\"required\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Only numbers and phone characters (#, -, *, etc) are accepted.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-Emergency1 elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-Emergency1\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tEmergency Contact Name 1\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[Emergency1]\" id=\"form-field-Emergency1\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Emergency Contact Name 1\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-tel elementor-field-group elementor-column elementor-field-group-Emergencyph1 elementor-col-50 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-Emergencyph1\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tMobile Phone\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input size=\"1\" type=\"tel\" name=\"form_fields[Emergencyph1]\" id=\"form-field-Emergencyph1\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Emergency Mobile Phone 1\" required=\"required\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Only numbers and phone characters (#, -, *, etc) are accepted.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-Emergency2 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-Emergency2\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tEmergency Contact Name 2\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[Emergency2]\" id=\"form-field-Emergency2\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Emergency Contact Name 2\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-tel elementor-field-group elementor-column elementor-field-group-Emergencyph2 elementor-col-50\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-Emergencyph2\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tMobile Phone 2\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input size=\"1\" type=\"tel\" name=\"form_fields[Emergencyph2]\" id=\"form-field-Emergencyph2\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Emergency Mobile Phone 2\" pattern=\"[0-9()#&amp;+*-=.]+\" title=\"Only numbers and phone characters (#, -, *, etc) are accepted.\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-acceptance elementor-field-group elementor-column elementor-field-group-Agree elementor-col-100 elementor-field-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-Agree\" class=\"elementor-field-label elementor-screen-only\">\n\t\t\t\t\t\t\t\tAgree\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-subgroup\">\n\t\t\t<span class=\"elementor-field-option\">\n\t\t\t\t<input type=\"checkbox\" name=\"form_fields[Agree]\" id=\"form-field-Agree\" class=\"elementor-field elementor-size-sm  elementor-acceptance-field\" required=\"required\">\n\t\t\t\t<label for=\"form-field-Agree\">I agree to the terms and conditions<\/label>\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-html elementor-field-group elementor-column elementor-field-group-field_5702271 elementor-col-100\">\n\t\t\t\t\t<span style=\"font-size:0.7em; line-height:0.2em !IMPORTANT\"><b>TERMS AND CONDITIONS<\/b> I (the owner\/caregiver) hereby declare to Eastside Pups that I am the legal owner of my dog; that my dog has not been exposed to distemper, rabies or parvo within the last 30 days and that my dog has been properly vaccinated as indicated by the records presented, and that my dog is currently and correctly registered. I understand that even though all guests at Eastside Pups are vaccinated; this may not fully protect my pet. Your vet will advise further on this issue. \n\nI understand that Eastside Pups reserves the right to refuse admittance to your dog at any time if problems arise from their behaviour. Any behaviour deemed dangerous or inappropriate by Eastside Pups or its staff may result in dismissal of my dog(s) from the facility. Note, we will always work with you first in this instance, with training advice and solutions wherever possible. \n\nEvery dog reacts differently and animals, by nature, are unpredictable and, therefore, present a certain level of risk. By using our service, you acknowledge and understand that there are certain risks involved in participating in day care and that Eastside Pups or its staff will not be liable for any injuries or illnesses resulting during your dog\u2019s attendance. In the unlikely event that your dog is injured by another dog, you will not hold Eastside Pups or its staff responsible for the injury. If your dog injures another dog or person, you will be solely responsible for the injury. By using our services, you accept that you may be liable for any expenses occurred due to the actions of your dog including, but not limited to, medical expenses and damage to property. \n\nEastside Pups staff are trained in Pet First aid including CPR. In the event of an emergency, every attempt will be made to contact the dog\u2019s owners and the Emergency Contacts listed on this form. If contact cannot be made, then we will act in a way that we feel is in the best interest of your dog which includes providing professional veterinary services.\n\nPAYMENT I understand that payment is required for any daycare session using one of our concession passes or casual fees on the day. I understand that the hours of operation for daycare are 7am \u20136.00pm Monday - Friday and I may be charged a late fee for collecting or dropping off my pet outside of these hours. If my dog has not been collected by 6:00pm then arrangements for overnight boarding will occur. I have read and understood the above terms and conditions. \n\n\"All cancellations will now incur a cancellation fee depending on the notice given. If your dog can't attend for any reason, e.g. on holiday, sick, school break, kennels or for any other reason, the following applies: More than 24 hours\u2019 notice: $25 full day or $15 half day to hold your permanent placement. Less than 24 hours\u2019 notice: 100% of the daily service fee will be payable. 7 days\u2019 notice is required when you would like to cancel your permanent placement, or the policy above applies. 7days\u2019 notice is required when reducing or changing your permanent daycare day or the policy above applies.* Exceptions will be made for desexing. All other special circumstances \/ emergencies will be taken into consideration at management's discretion. Please speak to one of our staff members directly about this. If, for whatever reason, your dog cannot attend their weekly spot, placement can be held for a maximum of 2 weeks or at our discretion and may be terminated by us after that. Any dogs that no show or make no contact for 2 weeks will be considered an abandonment and be unenrolled automatically\"<\/span>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-recaptcha_v3 elementor-field-group elementor-column elementor-field-group-field_056a89d elementor-col-100 recaptcha_v3-bottomright\">\n\t\t\t\t\t<div class=\"elementor-field\" id=\"form-field-field_056a89d\"><div class=\"elementor-g-recaptcha\" data-sitekey=\"6LdM1fEqAAAAAFUPWIB826HGAVSTA0DFBSlUqjT-\" data-type=\"v3\" data-action=\"Form\" data-badge=\"bottomright\" data-size=\"invisible\"><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-md\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">SUBMIT<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>EASTSIDE PUPS DAYCARE ENROLMENT FORM All cancellations will now incur a cancellation fee depending on the notice given. If your dog can\u2019t attend for any reason, e.g. on holiday, sick, school break, kennels or for any other reason, the following applies: More than 24 hours\u2019 notice: $25 full day or $15 half day to hold [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"class_list":["post-188","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>ENROLMENT FORM - EastSidePups<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/eastsidepups.co.nz\/enrolment-form\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ENROLMENT FORM - EastSidePups\" \/>\n<meta property=\"og:description\" content=\"EASTSIDE PUPS DAYCARE ENROLMENT FORM All cancellations will now incur a cancellation fee depending on the notice given. 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