Canine Country Getaway

Getaway Registration Form

Today's Date:____________________

Name:_______________________________________________________________________

Address:_____________________________________________________________________

City:___________________________________ State:_____________ Zip:_______________

Tel:__________________________Email:__________________________________________

Dog(s) attending:
For each dog, please list: breed, name, age, and indicate if spayed/neutered.

_____________________________________________________________________________

Proof of rabies vaccination or titer required with registration.

Spay/Neuter Policy: Only one unneutered male dog may attend at any given time with other dogs.
Must be discussed and approved prior to registration. Female dogs in heat are not accepted at the Getaway.

Reservation Dates:

1st choice dates:__________________________

2nd choice dates:__________________________

1st & 2nd choice lodging:

_______ Large Cottage

_______ Small Cabin

_______ RV Rental

_______ Own RV

Lodging is booked first-come, first-served. Lodging fees support the rescue efforts at the Farm.

Number of People camping:___________
Campers must be 18 years or older.

Total $ enclosed:____________________

Deposit of 50% is due at the time of booking. The remaining balance is due 30 days prior to arrival.
Lodging at the Farm is limited to first come, first serve and is in great demand due to the smaller size
of the camp, with only five RV's and four cabins. Once booked, a deposit of one night's stay will not
be refundable, in the event of any cancellation. Full camp fee, less deposit, will be refunded if
notification is 30 days before arrival. After thirty days, any cancellation refunds will be dependent
on our ability to fill your space.