Dog Park Registration – Audubon Square/Fallbrook Community HOA Website

Date:

Pet Owner Name:

First

Last

Address:

Address Line 1

Address Line 2

City

State

Zip Code

Phone:

Email

Pet Name:

First

Last

Primary Breed:

Has your pet been altered?

Yes
No

Primary Color:

Pet Date of Birth:

Spay/Neuter Date:

Rabies Vaccine Expiration Date:

Name of Veterinarian or Clinic that Administered Rabies Vaccine:

Telephone Number of Veterinarian or Clinic that Administered Rabies Vaccine:

Copy of Current Rabies Vaccination Certificate Copy of Spay/Neuter Certificate or Signed Affidavit (see below) Processing Fee (applications cannot be processed until the Association has received the Processing Fee) Microchip Number (if applicable) Secondary Breed Secondary Color There is a $10.00 processing fee to cover the cost of the dog tag and the key that allows entry into the park. Payment can be made in the same manner as your assessment payment. You may forward the e-receipt and completed application to your community manager for faster processing. The dog tag and key will be mailed to the applicant. No dogs that have not been neutered are allowed in the dog park.

Copy of Current Rabies Vaccine Certificate:

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Copy of Current Spay/Neuter Certificate

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SPAY/NEUTER AFFIDAVIT

By checking this, I hereby certify that my pet named above has either been spayed or neutered by vet/clinic named above on/or about the indicated date OR was spayed/neutered while owned by a previous owner and documentation to verify the surgery is unavailable.

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