Book Exploration Vacation Please fill out the form below and someone will be in contact soon! Name * First Name Last Name Phone * (###) ### #### Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Emergency Contact Information Emergency Contact Name * Please provide a contact other than yourself and ensure this person is not going to be away with you during your absence. Emergency Contact Relationship * Emergency Contact Phone Number * Veterinary Information Veterinarian Name * Veterinarian Address * Veterinarian Phone Number * Pup 1 Dog's Name * Breed * Date of Birth * Is this your dog's first time at WildFree Canine? * Yes No Gender * Is your dog spayed/neutered? * Food Brand * Social Skills * How is your dog's recall? * Pup 2 Dog's Name Breed Date of Birth Gender Is this your dog's first time at WildFree Canine? Yes No Is your dog spayed/neutered? Food Brand Social Skills How is your dog's recall? * Pup 3 Dog's Name Breed Date of Birth Gender Is this your dog's first time at WildFree Canine? Yes No Is your dog spayed/neutered? Food Brand Social Skills How is your dog's recall? * Exploration Vacation Services What dates are you looking to book? Start Date * MM DD YYYY End Date * MM DD YYYY Which adventure package would you like? * Earth - recommended for senior dogs or dogs without great recall Wind - consists of the dogs having free rein of the entirely fenced in WildFree Farm Do you require a Shuttle Service? * Complimentary Shuttle Service to: - From your home in Bowden, Sundre, Cremona, Olds and surrounding areas with a 5 night minimum Exploration Vacation Booking - From your home in Red Deer, Innisfail, Calgary, Airdrie, Okotoks, Cochrane and surrounding areas with a 7 night minimum Exploration Vacation Booking - Otherwise the cost $150.00 + GST, round trip. This is a flat rate and Jax will drive anywhere within 2 hours of the Wild Free Farm Yes No If you are dropping off, please choose a drop off time: 5am 6am 7am 8am 9am 10am 11am 12pm If you are picking up, please choose a pick up time: 5am 6am 7am 8am 9am 10am 11am noon To be mindful of Jax’s work life balance, there are specified pick-up and drop off. If you are late and arrive to either pick up or drop off outside of these time windows, there will be a $50 Late Pick Up Fee charged on your invoice. Please be respectful and try your best to plan ahead so that Jax can schedule her time accordingly. Thank you in advance!! Is your dog a bed chewer? If yes, please explain * If yes, please provide your own bedding Is your dog prone to escaping? If yes, please explain * ie: crates, kennels, yards, houses, etc. How did you hear about WildFree Canine Inc. * Are you a WildFree Raw Food Customer? * All WildFree Raw Food Customers receive 50% off all Exploration Vacation (minimum of 2 boxes per month) Yes No Is your dog a WildFree bred Border Collie? * If your dog is a WildFree bred Border Collie, you receive a discount off Exploration Vacations Yes No Any additional information or questions? Thank you for submitting your Exploration Vacation request. Please note that this does not mean that your booking has been accepted. Jax will be responding to you soon. If you don’t hear from her within 48 hours, please email js@wildfreecanine.com or submit this form again!