Facility Dog Application

Facility Dog Application

New Life K9s
Facility Information
Facility/Organization Name*
Facility Address*

Street Address

Street Address Line 2

CityState

Zip Code
Facility Phone Number*
Facility Website
Please include information below for the primary responsible person who will be approving a facility dog at your location. This would likely be a President, Director, Manager, or Owner.

Information for the daily dog handler will be asked in a separate application.
Approving Person Name*
Approving Person Phone*
Please enter a valid phone number.
Approving Person E-mail*
example@example.com
Additional Notes

Dog Handlers
Will the dog be going home with someone after hours?*

Yes (will require 2 handlers minimum)No (may require 3 handlers - one handler for each shift)Myself, I am a solo operation
Do you have employees who have agreed to be dog handlers?*

YesNot Yet
A primary and secondary handler is required at minimum. The dog needs to be assigned to a responsible person 24/7. Consider who will be responsible for the dog during the day vs night. Who will be responsible when someone is sick or on vacation.
Handler Name 1

First NameLast Name
Handler Name 2

First NameLast Name
Handler Name 3

First NameLast Name
What is your plan for finding dog handlers?*
Please have the dog handler(s) complete the Dog Handler Application.

Handler Application
Please complete the Dog Handler Application after you finish this application.

I indemnify and hold New Life K9s harmless from and against all claims, losses, and/or liabilities for damage done by the dog to any person or property. I indemnify and hold New Life K9s harmless from and against all governmental charges or fines and attorneys’ fees arising out of the acts or omissions of New Life K9s, including but not limited to interactions with instructors, attendees, incarcerated handlers, involved in instruction and placement.

I acknowledge that the information contained on this form is true and correct to the best of my knowledge. I understand that any misrepresentation of facts may result in the removal of the dog from the facility.

I acknowledge that New Life K9s does not provide financial assistance to clients.
Type Your Name*

First NameLast Name
Your Email*
example@example.com
Your Position*
Signature*

Clear
Date*

MonthDayYear
Date
Hour MinutesAM/PM Option
Should be Empty:

Facility Information