Pet Care Online Registration

Betreuung von Hunden

Name*		Telephone*
First name*		E-mail*
Street*		Fax
Postcode*		Mobile
City*		Network
District		Date of birth
* mandatory items

Person to contact in emergency, with telephone number:

My dog is	male	female
	sterilized	castrated

Breed:

Name:

Age:

Period of time

from:

up to:

I would like the following from the guest family

house with a garden	not together with any other animal of the same breed
ground floor flat	not together with any other animal of any breed
elderly guest family	no children
family with children from the age of

About my dog

likes to be cuddled	drags when on the lead	puppy
likes to play with toys	when taken out, must be on a lead	not house trained
impetuous	compulsory, must be taken out on a lead	likes to sleep in bed
well behaved	barks when left alone	likes to sit on the couch
greedy	house-trained	does not like a lot of fuss, prefers to be left alone.

My dog can be left alone for approximately

up to 1 hour

1-2 hours

3-4 hours

5-6 hours

cannot be left alone

Any other characteristics my dog may have:

Please give us your personal liability insurance, without this we cannot accept your animal.

Name of the company:

Policy number:

Payment options

1. Bank Transfer / Invoice

7 days after receiving our invoice for the Agency Fee / Processing Fee the sum is payable.

2. Direct Debit Authorisation

The Tiersitterservice-NRW is hereby authorized to draw in by debit, the payment charges for the once only handling charge of 10€/25€, as well as the commission fees. Please give us your bank details:

Account holder
Account number
Name of Bank
Bank sorting code

I have read the GTC and the Price List and accept them. (This button must be activated in order to send the registration form.)

Please note: We will report back on the third day at the latest after you have sent the registration form. If not, please contact us via mail or phone. In rare cases it is possible that your registration form is not submitted correctly. Thank you.

Please type in the safety code against spam mailings.

If you experience any problems with submitting the registration form, we can also send it to you via E-mail. Write to .