Group Class Application
Dog Information:
Name: ______
Breed: ______Male or Female ______
Age: ______
Spayed or Neutered? (Yes or No) ______
Giardia Tested - For Puppies only (Yes or No) ______
Vaccinations:
§ Rabies (Yes or No) ______Date: ______
Owner Information:
Name: ______
Address: ______
City: ______State: ______Zip: ______
Phone: (H)______
Cell: ______
E-mail address: ______
Vet Information:
Name: ______
Address: ______
City: ______State: _____Zip: ______
Phone: ______
Did someone refer you? ______
Who? ______
CLIENT RELEASE
I understand that, despite fill in name of facility best efforts to maintain the safety of every dog and human at fill in name of facility facilities, there are certain risks involved in doggy training classes. These risks include but are not limited to my dog contracting fleas, kennel cough or some other communicable illness. I voluntarily accept these risks, and release fill in name of facility and its employees, independent contractors, owners and assigns from any and all claims arising out of injury or damage in any way related to or resulting from my association with fill in name of facility, including but not limited to claims of injuries to my dog, myself or to any property that belongs to me. I understand and agree that dogs can be unpredictable and that if my dog becomes injured while at fill in name of facility training I will be responsible for my dog’s veterinary bills and any other costs incurred due to the injury. I understand and agree that this release applies to future unknown or unsuspected claims.
I represent that my dog is currently in good health and has not had any communicable illness of any kind for two weeks prior to attending fill in name of facility training classes. I will wait ten days before bringing my dog to fill in name of facility after any dog kennel overnight. I further represent that each time I bring my dog to fill in name of facility, I am re-certifying that my dog is in good health and has not had any communicable illness of any kind for two weeks prior to such attendance.
I represent that my dog is currently protected by a flea care preventative and that my dog will be protected by this preventative throughout each and every day my dog attends fill in name of facility, each time I bring my dog to Fill in name of facility. All media (pictures, videos, etc.) at Fill in name of facility are the property thereof.
I represent that my dog does not have a history of aggressive behavior towards other dogs or humans.
I warrant that I am at least eighteen (18) years of age and that I have the full, complete and unrestricted right and authority to enter into this release.
Print Name: ______
Signature: ______
Date: ______
TERMS & CONDITIONS
Your name or company name cannot make any guarantee regarding the outcome of any training/counseling program. The owner assumes full responsibility for the dog’s behavior during and after the training/counseling program. Owner Initial
TERMINATION OF TRAINING
The owner of the dog(s) may have the animal withdrawn from training at any time, however, once training has begun; all fees are non-refundable.
LIABILITY
I, ______as the legal owner/agent of the abovementioned pet(s), having carefully read and fully understand this agreement, do hereby waive and release Your name or company name and Fill in name of facility from any and all liability of any nature. This includes any injury, death, sickness or damage my pet may suffer during or after any training program. I also agree to indemnify and hold harmless Your name or company name and fill in name of facility from any and all claims due to damage the pet may cause to any family members of any third parties during or after training. The owner specifically acknowledges that they recognize the risk of taking a group class with other people and their dogs. This risk is entered into with the owner 100% responsible for their dog’s behavior at all times in the class environment.
MISCELLANEOUS
The owner/agent will be responsible for purchasing all necessary equipment that the trainer recommends for training the dog(s).
In the event either party deems it necessary to employ legal counsel to protect its rights under this agreement, the prevailing party agrees to pay all expenses including, but not limited to costs and reasonable attorney’s fees.
This training agreement represents the full and only agreement between the parties. The terms and conditions set forth in this agreement cannot be modified or changed in any way unless agreed to by both parties in writing. I have read, fully understand and agree to the above contract terms.
Print Name
______
Signature Date