MINDful Day School Registration Form

MINDful Day School Registration

Please complete form to finalize your MINDful Day School Registration (for selective/reactive dogs). Canine Crews staff will respond to confirm dates and finalize scheduling the sessions. Please understand that these are set up as Monthly Automated Passes as we require a 30 day commitment, 2 times a week, with you and your dog in order to see proven results.
Owner Information
How did you hear about us?*

Customer referralProfessional referral (trainer/vet)Google AdsSocial Media AdsEvent/FestivalOther
If referral, please name as we give credit for referrals
Customer or company name
Full Name*

First NameLast Name
Gender Pronouns
She/He/They, etc
Mobile Number*

Area CodePhone Number
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Instagram Handle:
If you would like us to tag you in photos/videos
Spouse/Partner Information
Spouse/Partner Name

First NameLast Name
Gender Pronouns
She/He/They, etc
Mobile Number

Area CodePhone Number
E-mail
example@example.com
Emergency Contact Information
The emergency contact must be someone other than yourself and spouse/partner. We will always try to contact you first but need another option if you are traveling or out of the country.
Emer Contact Name*

First NameLast Name
Gender Pronouns
She/He/They, etc
Mobile Number*

Area CodePhone Number
E-mail
example@example.com
Dog Information
Dog Name*
Gender*
Breed*
Color/Markings*
Age*
Birthdate*
Weight*
Spayed or Nuetered?*

YesNo
If no, when scheduled?
Veterinary Information
Name of Veterinarian Office*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Veterinarian you see?

MINDful Day School Monthly Automated Pass

Our day school requires a 30 day commitment and we run the monthly charges at the 1st of every month.
MINDful Day School MAPs

8 pass (2x/week) - $600Other
Terms & Conditions
My dog's complete veterinary inoculation records must be furnished to Canine Crews including rabies, Distemper Combo (DHLPP), bordatella and a negative fecal exam for parasites. I also understand that Canine Crews recommends the canine influenza vaccine.
My dog must be spayed or neutered unless younger than six (6) months of age.
I understand that I am required to communicate any known illness in my own dog(s) at any time to Canine Crews to allow for full disclosure to all clients regarding illness.
I understand that the MINDful Day School experience far outweighs the risks and know that participating may expose my dog to various airborne and nose-to-nose contagions. Including, but not limited to: canine cough, giardia, upper respiratory infections and papilloma virus
Client Agreement and Release of Liability
This Agreement is between Canine Crews, LLC., and any one or more of its locations or any other affiliate as may be created or established by Canine Crews and for the purposes of obtaining a membership with Canine Crews by the client.

This Agreement applies to all MINDful Day School Monthly Passes with Canine Crews, including but not limited to all monthly pass memberships and unlimited memberships. These memberships are month to month, with no minimum commitment. Cancellations must be received 7 days prior to transaction date (1st of each month) to ensure no charges on card. All Single Day charges will be applied at checkout on day activity is scheduled.
Canine Crews Credit Card Authorization Agreement:

I (we) authorize Canine Crews to run my credit card provided in onboarding. This deduction may continue until Canine Crews and my (our) bank have received written notice from me (us) of its termination. The account may be debited on, or within a few days before or after the above bill date. I authorize Canine Crews to debit my (our) account for all sums which are owed,including any extra costs incurred as a result of additional collection efforts.

By clicking below, I (we) allow authorization for the above.
Canine Crews reserves the right to increase the monthly dues in its sole and absolute discretion. Nothing set forth herein shall be deemed to obligate Canine Crews to fix for a specific duration of time the price of any specific good or service (including, without limitation Monthly Pass dues) unless said cost is fixed for a specific duration of time in accordance with the a written agreement between Canine Crews and the Client. Canine Crews acknowledges that we intend to provide a minimum of 30 days notice prior to any price adjustment.
Canine Crews reserves the right to suspend or terminate the Monthly Pass at its sole and arbitrary discretion.

Client understands that their dog may not enjoy or do well in our MINDful Day School and that Canine Crews has procedures and communication in place to resolve many issues; but reserves the right to cancel the Monthly Automated Pass at any time. Client also agrees that if their dog shows any type of behavioral issues that compromise the safety of other dogs, staff or clients, then their MINDful Day School Monthly Pass will be revoked.
I understand that by signing here, I agree to all terms.

Clear
Should be Empty:

MINDful Day School Registration

Dog Behavior Questions

MINDful Day School Monthly Automated Pass