Sign Up Process:

Step 1: Please ensure you have read through our Frequently Asked Questions

Step 2: Complete this application.

Step 3: Once submitted we will contact you to schedule an initial visit at your home.

Step 4: After the visit you will receive a welcome email with details on how to login and request Breaks.


* Required

Primary Contact * First Name:
* Last Name:
* Mobile Number (Enter home phone if no mobile): () -
* Home Phone (Enter mobile if no home phone): () -
* Email:
* Street Address:
* City:
* State:
* Zip:

* Would you like to receive a text message when we arrive for Ruff / Fast Breaks?:
Text messages will be sent to the mobile number entered above.
Yes:
No:

Spouse or Secondary Contact First Name:
Last Name:
Phone Number:() -
Email:

Emergency Contact This person can make decisions if primary or secondary contact cannot be reached

* First Name:
* Last Name:
* Phone Number:() -
* Relation:

Home Access Check all that apply to access your pet(s):
Details will be discussed with you during the initial visit

Key To Front Door Front Door Keypad Key To Side/Other Door
Garage Keypad Owner Will Be Home Hidden Key
House Alarm Lock Box Hotel Room/Suite

Ruff Break Schedule I will primarily schedule Ruff / Fast Breaks as needed:
I will primarily need pet sitting:
I need Ruff / Fast Breaks on the same day(s) each week:
Applicable only if Ruff / Fast Break days will not change or change very infrequently

My preferred schedule: (Select break type and time for each weekly recurring day)
Day Of The Week Break Type Time
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Veterinary Information * Vet Hospital or Clinic Name:
* Address:
* City:
* State:
* Zip:
* Phone Number: () -

General Information For All Pets Where do you keep your pet food?
Where do you keep your pet treats?
Where do you keep leashes and/or collars?
Where do you keep general cleaning supplies?

Pet Sitting Options Bring in mail:
Yes:
No:

Turn on a light at night:
Yes:
No:




Pet 1 * Name:
* Breed:
* Birth Year:
* Color / Unique markings:


Is this pet a cat? Yes:No:

I currently exercise this pet by I would like Ruff Break to try
Walking
Walking with a dog backpack
Jogging
Playing fetch in yard
Biking
Roller Blading
Weight pulling
No Exercise/Physical Limitations
Walking
Walking with a dog backpack
Jogging
Playing fetch in yard
Biking
Roller Blading
Weight pulling















* Name:
* Breed:
* Birth Year:
* Color / Unique markings:


Is this pet a cat? Yes:No:

I currently exercise this pet by I would like Ruff Break to try
Walking
Walking with a dog backpack
Jogging
Playing fetch in yard
Biking
Roller Blading
Weight pulling
No Exercise/Physical Limitations
Walking
Walking with a dog backpack
Jogging
Playing fetch in yard
Biking
Roller Blading
Weight pulling















* Name:
* Breed:
* Birth Year:
* Color / Unique markings:


Is this pet a cat? Yes:No:

I currently exercise this pet by I would like Ruff Break to try
Walking
Walking with a dog backpack
Jogging
Playing fetch in yard
Biking
Roller Blading
Weight pulling
No Exercise/Physical Limitations
Walking
Walking with a dog backpack
Jogging
Playing fetch in yard
Biking
Roller Blading
Weight pulling















* Name:
* Breed:
* Birth Year:
* Color / Unique markings:


Is this pet a cat? Yes:No:

I currently exercise this pet by I would like Ruff Break to try
Walking
Walking with a dog backpack
Jogging
Playing fetch in yard
Biking
Roller Blading
Weight pulling
No Exercise/Physical Limitations
Walking
Walking with a dog backpack
Jogging
Playing fetch in yard
Biking
Roller Blading
Weight pulling















* Name:
* Breed:
* Birth Year:
* Color / Unique markings:


Is this pet a cat? Yes:No:

I currently exercise this pet by I would like Ruff Break to try
Walking
Walking with a dog backpack
Jogging
Playing fetch in yard
Biking
Roller Blading
Weight pulling
No Exercise/Physical Limitations
Walking
Walking with a dog backpack
Jogging
Playing fetch in yard
Biking
Roller Blading
Weight pulling