Training Services Contract

Please select a Service type*

Date of first class or appointment (if scheduled)

Date

Dog Information

Tell us about your dog*

	Name	Age Now	Gender	Spay/Neuter	Breed-Type	Weight	Color
Dog Info

Are you registering a second dog?

	Name	Age Now	Gender	Spay/Neuter	Breed-Type	Weight	Color
Dog Info

Your Information

Your Name*

First NameLast Name

Preferred Phone Number*

Second Number

E-mail*

Disability

Any Disability we should be aware of

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Other Family Members

	Name	Age (children)	Any Disability	Email address	Phone
Spouse/Adult 2
Child / Adult 3
Child / Adult 4
Child / Adult 5
Child / Adult 6
Child / Adult 7
Child / Adult 8

Where did you get your dog?*

Rescue, Breeder, Pet Store, Shelter - Include any history you know about before s/he came to you.

When did you get your dog?*

How old was s/he then?

Reason for Training *

How did you hear about The Refined Canine, LLC?*

How much and what do you feed your dog? *

Please list brand and amount of food

Veterinarian Information

Veterinarian Name*

First NameLast Name

Vet Phone Number

Vet Address

Vet Hospital Name

Street Address

CityState / Province

Postal / Zip Code

Date of Last Vet Visit*

MonthDayYear

Summary/Outcome: Please list any ongoing health issues or medications*

Date of last fecal test or treatment for intestinal parasites*

MonthDayYear

DUE DATE for next Rabies vaccine or titer*

MonthDayYear

DUE DATE for next DHLPP Vaccine or titer*

MonthDayYear

Do you have any questions for us?

Liability Waiver & Acknowledgement

I acknowledge that all fees are non-refundable.
I understand that services must be used within six months. If I must cancel a lesson or miss a class, I will notify my instructor in advance of the scheduled lesson or class time. Private lessons will be rescheduled if I have given 24 hours notice. Make-up classes will be offered, when available, if I have given 24 hours notice. Exceptions for emergency situations may be considered on an individual basis, but are not guaranteed. I understand and accept that it is my responsibility to schedule lessons in a timely manner, and that after six months with no contact from me, my contract will expire and all remaining lessons or classes will be forfeited.
I understand that The Refined Canine, LLC and all agents and partners thereof make no guarantees regarding the success of training endeavors, or the rehabilitation or modification of behavior problems. The Refined Canine, LLC, and all agents and partners thereof assume no responsibility for the behavior of any dog(s) currently enrolled in any training or behavior modification program. I accept full responsibility for the behavior of my own dog at all times.
I understand that The Refined Canine, LLC and all agents and partners thereof assume no responsibility for the health and safety of myself, my family and my dog.
I understand that all materials produced, published, distributed or shared during the course of training are copyrighted materials and are shared with permission, and they are not to be reproduced or distrubuted without express permission of the original authors.
I agree not to reproduce or distrubute any materials, print or electronic, that have been pulished by Michelle Douglas or The Refined Canine LLC, except those which are listed publicly online.

Media Release & Authorization

I agree to allow The Refined Canine, LLC and my instructors to take video and photpgraphs during classes or lessons, and to use any media which may contain myself, my dog, or my family for educational or marketing purposes, including but not limited to seminar presentations, online publishing and printed materials. I hereby release The Refined Canine, LLC, and its employees or agents from any and all claims for damages based on such materials. I release all claims of copyright ownership of such materials to Michelle Douglas and The Refined Canine, LLC. I agree to allow Michelle Douglas and The Refined Canine, LLC to use information about my dog and our case for educational purposes. I understand that my personal information will remain confidential.

COVID-19 & Viral Illnesses Standard Business Waiver

I acknowledge the contagious nature of the coronavirus/COVID-19, Influenza, and other viral illnesses, and that many public health authorities recommend practicing social distancing.
I further acknowledge that The Refined Canine LLC can not guarantee that I will not become infected with the coronavirus/COVID-19, Influenza, or any other viral illnesses. I understand that the risk of becoming exposed to and/or infected by the coronavirus/COVID-19, Influenza, and other viral illnesses may result from the actions, omissions, or negligence of myself and others, including, but not limited to, staff, and other clients and their families.
I voluntarily seek services provided by The Refined Canine LLC and acknowledge that I am increasing my risk of exposure to the Coronavirus/COVID-19, Influenza, and other viral illnesses.
I hereby release and agree to hold The Refined Canine LLC harmless from and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses, and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of The Refined Canine LLC, or that may otherwise arise in any way in connection with any services received from The Refined Canine LLC.
I understand that this release discharges The Refined Canine LLC from any liability or claim that I, my heirs, or any personal representatives may have with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any services received from The Refined Canine LLC.
This liability waiver and release extends to The Refined Canine LLC together with all owners, agents, partners, and employees.

Training Services - Fee Disclosures 2023
Fees are subject to change without notice
The State of CT adds a 6.35% Sale Tax on Dog Training Services

Virtual Classes (pre-recorded): $100

Weekly Group Classes - six-week sessions: $250
- Puppy Social Skills
- Basic Canine Life Skills
- Refining the Basics
- Refined Tricks & Games
- Refined Recall & Leash Skills

Private Training Lessons in your home or on location
- One 1-hour lesson: $150
- Three 1-hour lessons: $400
- Five 1-hour lessons: $650

Refined Real World (Once a month on Saturdays - Pre-registration required)
- Drop-In one time: $40
- Package of four: $140

Packages (must be paid at the first lesson or class)
- $500 for three 1-hour private lessons plus four REAL WORLD classes
- $600 for three 1-hour private lessons plus one 6-week group class

Additional Fees
- $50 for every 15 minutes of travel over an hour round trip
- $50 for every 30 minutes of lesson time over 1 hour

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Type Signature*

Tying your name is legally binding as an electronic signature.

Signature

Refined Canine Training Contract 2023