Woof Houze Puppy Training Academy

Full Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number*

Area CodePhone Number

E-mail*

Emergency Contact Name*

First NameLast Name

Emergency Contact Number*

Area CodePhone Number

How Did You Hear About Us?*

How Many Children Do You Have?*

When Are You Hoping To Enroll Your Pup? This is Only With An Approved Application*

Which Program Are You Interested In? School Days are M,W,F 8am-5pm Transportation Is Available.*

One Month Trial One Payment of $595 (3 School Days 1 Private)PuppyHood Made Simple PT. Time $2200 (12 weeks/20 classes)PuppyHood Made Simple Full Time $4400 (12 weeks/40classes)Customized Package Begins at $999I Need Help Deciding

Please Provide Multiple Days Times For Your Pups Evaluation? The Cost is $149.00. This Is Mandatory For Your Canines Application To Be Considered.*

Do You Understand That we Require Payment In Full Before Class Can Begin? (Alternative Payment Options Available.)*

YesNoI Need Payment AlternativesHelp Me to Make This Work

Do You Understand That You Must Participate In The Trainings? Also That You Will Have Homework?*

YesNoNeed To Find TimeI'll Do My Best

If Approved, Does Your Canine Need Transportation? Costs begin at $20 each way.

Pickup OnlyDrop Off OnlyDrop Off & PickupWe Don't Need Transportation

Have You Ever Owned A Canine? If so what age was the canine when you acquired him/her*

Have You Ever Trained A Canine? If so what age?*

Briefly State What You Hope To Accomplish In Puppy Training Academy:*

Canine Information

Canine's Name*

Breed*

Age*

How Old When You Acquired Your Pup?*

Gender*

MaleFemale

How Long Have You Owned The Canine?*

Has Your Dog Been:*

SpayedNeuteredNone of the Above

Where Did You Acquire Your Canine?*

Where Does Your Canine Sleep At Night?*

Are You Currently House Training or Using Pee Pads?*

Behavior Problems Of Parents Or Littermates, if Known?*

Veterinary Information

Veterinarian

Vet Clinic

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Is Your Dog Current On All Age Appropriate Vaccinations ?*

YesNoI Don't Vaccinate, I Use Tither Testing

Vaccination Dates If It Applies:

Bordatella:*

DHLP:*

Please List All Medications Your Canine Is Currently Taking. Please Include Heartworm, Flea and Tick Medications, etc*

Please List Any Medical Problems Your Canine Has Had:*

Behavior Information

Describe Any Previous Obediance Training:

Level Of Success?

What Commands Currently Work Best?

Which Member Of The Family Has The Best Control?

Does Your Canine Know How To Walk On A Leash?*

YesNo

Handling & Grooming Is A Part Of Our Learning Syllabus. How Does Your Dog Respond To The Following Tasks?

Trimming Nails?*

Giving Pills?*

Cleaning Ears?*

Grooming?*

Bathing?*

Patting Head?*

Grasp Collar?*

Being Lifted?*

Rolling Over*

Tell Us About Any Correction Techniques You Have Used And Their Effect On Your Canine’s Behavior:

Time Out*

Leash Correction*

Verbal Scolding*

Noisemaker*

Water Spray*

Rollover*

Other*

Other Description, If Needed:

Behavior Problems:*

Describe Unwanted Behavior In Greater Detail:*

Describe How Your Dog Reacts To The Following Times When Left Alone:

During The Day:

During The Evening:

What Is Your Dog's Reaction To Your Departure?*

What Is Your Dog's Reaction To Your Homecoming?*

Do You Use A Crate?*

YesNo

Does Your Dog Like The Crate?*

YesNo

How Long Is Your Canine Left In The Crate. Number Of Total Hours Per Day?

Does Your Canine Exhibit Any Of The Following Behaviors, and When Does It Occurs (Ex. With Men Or In The Car)

Cowering

Ears Back

Tail Tucked

Retreating

Hiding

Excessive Salivating

Pacing

Please Give Additional Information Regarding Fear Or Anxiety In Your Dog:

Describe Situations Where Your Canine Appears Fearful And/Or Aggressive:

Do You Ever Muzzle Your Canine For Safety?*

YesNo

Is Anyone In Your Family Afraid Of Your Dog? If So, Please Describe:*

How Does Your Dog Respond To The Following Situations?

When Approached While Eating:*

When Approached With Treat Or Toy:*

When Dog Is Scolded:*

When Dog Is Pushed Off Furniture Or Bed:*

When Dog Is Approached While Sleeping:*

To Strangers Outside Of The House:*

To People Entering House/Yard:*

To Children Or Infants:*

While In Car To People Outside Of The Car:*

To Other Dogs In Your Home:*

To Other Dogs Outside Your Home:*

Ever Aggressive To Family Members?*

YesNo

Has Your Dog Ever Bitten A Person?*

YesNo

Has Your Dog Ever Been Reported To Animal Control For Biting?*

YesNo

NO REFUNDS - NO CLASS CHANGES

AGREEMENT TO HOLD HARMLESS, WAIVER AND ASSUMPTION OF RISK

I understand that attendance of a puppy obedience training class through Woof Houze Puppy Training Academy is not without risk to myself, members of my family or guests who may attend, or my dog, because of some of the dogs to which I will be exposed may be difficult to control and may be the cause of injury even when handled with the greatest amount of care.

I hereby waive and release Woof Houze Canine Coaching & Wellness, LLC. DBA Woof Houze / woofhouze.com hereinafter referred to as the "Training Organization", its employees, contractors, officers, members and agents from any and all liability of any nature, for injury or damage which I or my dog may suffer, including specifically, but without limitation, any injury or damage resulting from the action of any dog, and I expressly assume the risk of such damage or injury while attending any training session, or any other function, of the Training Organization, or while on the training grounds or the surrounding area thereto.

In consideration of and as inducement to the acceptance of my application for training membership by this Training Organization, I hereby agree to indemnify and hold harmless this Training Organization, its employees, officers, members and agents from any and all claims, or claims by any member of any family or any other person accompanying me to any training session or function to the Training Organization, or while on the grounds or the surrounding area thereto as a result of any action by any dog, including my own. By placing your signature below, you are agreeing to the terms and releasing Woof Houze from any liability to your dog and yourself.

Signature

Clear

By Clicking The Submit Button You Agree To The Above Terms