Evaluation Request

Your Name*

First NameLast Name

Your Best Email*

example@example.com

Your Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Your Cell Phone Number*

Please enter a valid phone number.

Todays Date*

Date

People Authorized To Pick Up *

How did you hear about us?*

Do either you or your spouse work in Law Enforcement, Fire Services, or currently Active Military?*

NoYes

Some info about your pet

Do you already have an evaluation appointment set with us?*

YesNo

Is your dog crate trained?*

YesNo

Pet Name*

Breed*

Color*

DOB*

Sex*

Neutered/Spayed?*

YesNo

Does your dog have any underlying/chronic health conditions, or allergies/sensitivities? Please explain:*

Age Obtained*

From/Breeder (name of breeder)*

Rescue (name of rescue)*

Have you ever owned a dog before?*

YesNo

State what areas you are having problems? Please be specific. *

What type of training are you hoping to accomplish with your dog?*

Has you dog had any previous training? If yes, what type and where? *

Where is your dog allowed at home?*

Name of Veterinary Clinic?*

Copy of vaccination record (please upload here. We require your dog be up to date on Rabies, Distemper/Parvovirus, and Kennel Cough before coming into our facility. Must be provided prior to evaluation appointment) *

*Dogs are required to be up to date on rabies, distemper, and kennel cough to attend.

Please verify that you are human*

Please List an Emergency Contact Name/Cell Phone other than your own (in the event we are unable to reach you)

Name*

First NameLast Name

Phone Number*

Please enter a valid phone number.

Policies and Procedures:
I the undersigned hereby waive and release that K-9 Top Performance, LLC, it’s staff, officers, members,, contractors, and agents are not liable for any injury or damage which I may suffer including specifically, but without limitation any injury or damage resulting from the actions of any dog, and I expressly assume the risk of such damage or injury while attending training sessions, or any other service while on the training grounds, or the surrounding area thereunto. The Owner represents that he/she is the legal owner of said dog. The owner represents that the titles to said dog are not mortgaged in any way.

Doggie Daycare & K-9 Camp Policies:
The Owner agrees that if he/she is injured by a dog at K-9 Top Performance, LLC they will not hold K-9 Top Performance, LLC liable for any injuries or damages that occur. The Owner has disclosed to K-9 Top Performance, LLC all known risks, dangers, and medical conditions associated with their
dog(s).

The Owner agrees that there are inherent risks in sending their dog to any canine activity center; such as illness, or injury, and Owner accepts these risks because they are outweighed by the benefits. K-9 Top Performance, LLC will not be liable for any illness or injury that may occur to my dog(s).

The Owner of said dog(s) below authorize K-9 Top Performance, LLC to take actions as they deem necessary to ensure the health, well-being, and safety of my dog(s), and to take reasonable action to resolve any medical problems that may arise while my dog(s) is in their care. The Owner agrees to assume full financial responsibility for any and all expenses incurred as a result of their
actions.

The Owner understands that as is the norm in the pet care industry, under no circumstances will K-9 Top Performance, LLC be liable for any damages beyond the replacement value of my dog(s). The Owner waives all claims or actions against K-9Top Performance, LLC relating to the care, control, health, and/or safety of my
dog(s) arising while my dog(s) is in their care.

The Owner understands that photography or other graphics, recordings, etc., may be made of my dog(s) at K-9 Top Performance, LLC and that such may be used for any purpose without compensation.

The Owner certifies that they are the legal owner of the dog(s) and their dog(s) is up to date on their Kennel Cough, Distemper, Parvovirus, and Rabies vaccinations. I will provide proof of my dog(s) vaccinations and understand that my dog(s) will be turned away for Daycare or K-9 Camp if my dog(s) vaccinations have expired.

*By signing and dating this form I aknowlage and agree to the above statements.

Date*

Date

Name*

First NameLast Name

Signature*

K9 Top Performance