Behaviour Modification Training Registration

Flying Monkeys Behaviour Modification

Program Registration Form
Your Information*

First NameLast Name
Address*
Phone Number*
Phone number
E-Mail*
example@example.com
Dog Information*

Name of DogBreed (s) of Dog
Gender*

MaleFemale
Is your dog spayed or neutered?*

YesNo
Date of Birth:*
Where did you get your dog from?*
Breeder, rescue, friend, etc.
Primary problem and reason for calling (The more detail provided the better we can create a customized training plan for your dog):*
What do you wish to accomplish?*
Is this a problem that has developed recently?*

YesNoOther
If yes, is there a specific reason or event that you know of that precipitated this behaviour?*
Please list the names of all training schools or private trainers with whom you have worked:*
List all schools, programs
Has your dog been to another trainer for the above described problem?*
What were recommendations and prognosis?
Training equipment used (including for walks):*
What training techniques have you tried?*
When was your dog's last health exam?*
Does your dog have any current medical problems?*
Does your dog have any allergies?*
Does your dog ever go to off leash dog parks or play off leash with groups of dogs?*
Do you use a crate for your dog? If you don't use a crate, why not?*
How long is your dog left alone during the day?*
What commands does your dog know and how well?*
What else would you like us to know about your dog?*
Upload a copy of your dog's vaccination records here:*

Cancelof

Please read and accept this waiver
I, the undersigned, am fully aware of any Government Mandated lockdown or stay-at-home orders as set out during this pandemic. I am of sound mind and body and will assume any and all risks involved in bringing my dog to Wizard of Paws for training or training related needs. I understand that at the time of booking my appointments that Wizard of Paws (WOP) is not showing any signs or symptoms of Covid-19, and that if any symptoms do arise, WOP will inform me accordingly. I understand that my appointment may be resheduled as a result. I do not or will not hold Wizard of Paws, nor its employees liable if I were to contract Covid-19 or any other illness.

In addition to the above, It is my understanding that notwithstanding the exercise of due care and control of the attending animals whether on my part, those of the other owner/handlers and employees of Wizard of Paws, all animal services, are not without risk, not only to myself, but also to family or guests who may attend as well as to my animal or other animals present.

I do hereby indemnify and release Wizard of Paws, its landlord, employees, owners and agents from any and all liability of any nature, for injury or damage that I; my animals; members of my family or guests may suffer, including specifically, but not limited to, any injury or damage resulting from the action or inaction of any animal or its owner or handler, or from the action or inaction of the landlord, Wizard of Paws or their employees, owners or agents, whether arising from negligence or any other reason or cause whatsoever and I expressly assume the risk of any such damage or injury while attending any training session or function of Wizard of Paws, either on the training grounds, facilities or the area thereto surrounding.

In consideration of, and as inducement to, the acceptance of my application for animal services of Wizard of Paws, I hereby agree to indemnify and hold harmless, Wizard Of Paws, its landlord, employees, owners and agents from any and all claims, suits, injuries, debts, demands, or charges of any nature or kind whatsoever which may be brought by me, or claims by any member of my family or other person accompanying me or my animal to any training session or function of Wizard of Paws, or while on the grounds or the area thereto surrounding, as a result of any action or inaction by any animal, including my own, or its owner or handler, or from the action or inaction of Wizard of Paws, its landlord, employees, owners or agents, whether arising from negligence or any other reason or cause whatsoever.
Signature*

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Please verify that you are human*
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Flying Monkeys Behaviour Modification