JP Dog Training Intake Form

*INSTRUCTIONS & DETAILS

Fill out form and upload required documents.
Once submitted, we will contact you to confirm receipt of your form, review available training options, and communicate your final steps for enrollment.
An assessment invoice will be emailed once all details are confirmed.
Payment is required prior to scheduling.

*Questions about this form? Email info@jpdogtraining.com

CUSTOMER DETAILS

FULL NAME*

Last Name:First Name:

ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

PHONE*

E-MAIL*

example@example.com

HOW DID YOU HEAR ABOUT US?*

IF REFERRED, PLEASE LIST NAME OF PERSON/ORGANIZATION THAT REFERRED YOU.

SERVICES INTERESTED IN:

NAME OF DOG(S):*

BREED OF DOG(S) - if more than one dog, please specify by name of each dog:*

SEX OF DOG(S) - if more than one dog, please specify by name of each dog:*

BIRTHDATE (00/00/00) OF DOG(S) - if more than one dog, please specify by name of each dog:*

WEIGHT OF DOG(S) - if more than one dog, please specify by name of each dog:*

WHAT ARE THE TRAINING GOALS OR NEEDS? (i.e. basic obedience, jumping, leash pulling, fear/anxiety, barking, aggression). If more than one dog, please specify for each dog.*

*HAS YOUR DOG EVER SHOWN SIGNS OF AGGRESSION/REACTIVITY TOWARDS DOGS OR HUMANS? (i.e. lunging, barking, biting, resource guarding). If more than one dog, list behaviors associated with each dog by name. Please be specific.*

*JP Dog Training is committed to helping both dogs and owners address obedience training goals and behavioral issues. The communication of behaviors and events that are aggressive, reactive, or concerning is vital for us to help you and also keep staff and dogs safe. Purposeful omission of known behavioral issues or events may result in the immediate removal of your dog(s) from our program(s) and facilities with or without notice or refund. Additionally, both client and dog may be banned from any future boarding or training with JP Dog Training or its affiliates. Client will be fully liable for all expenses related to any damage or loss incurred (i.e. facility, vehicle, belongings) and medical care for any dog or person injured as a result of the handling, caring, or transporting of the dog while in our care or at any time during any of our programs, including assessments.

VETERINARY CLINIC NAME:*

VETERINARY CLINIC PHONE NUMBER:*

Please enter a valid phone number.

VETERINARY CLINIC CITY:*

IS DOG(S) SPAYED/NEUTERED? - if more than one dog, please specify by name in the "other" option:*

YesNoOther

HEARTWORM MEDICATION BRAND AND DATE OF LAST DOSE - if more than one dog, please specify by name of each dog:

PLEASE UPLOAD PROOF OF CURRENT VACCINATIONS.

REQUIRED VACCINATIONS: Rabies, Parvo, Leptospirosis, Bordatella

PLEASE UPLOAD A PICTURE OF YOUR DOG(S).

IMPORTANT INFORMATION

Assessments and training cannot be scheduled until completed intake form, payment, and release forms have been received. Appointments and group class spots are filled on a first-come, first-serve basis once payment has been received. Group classes and private training sessions meet weekly at the same day/time for the duration of the course.

We believe you are the most vital part of your dog's obedience training. For it to be effective, it is imperative you implement and maintain the training as instructed by the trainer.

CLIENT AGREEMENT

PAYMENT: Full payment is required prior to the start of assessments or training. No refunds will be given once the training has commenced or in the event of a dog's removal by JP Dog Training staff.

ATTENDANCE: It is important to attend every session to learn our SIMPLE - PRACTICAL - PROVEN training methods. In the event of a planned or unplanned absence, client agrees to forfeit missed sessions without refund or rescheduling.

CLEANLINESS: Each owner/handler enrolled in a group class or private training sessions is responsible for the removal of excrement left by their dog.

EQUIPMENT/SUPPLIES: Each owner/handler is responsible to bring an adequate slip leash [5-6 foot recommended], collar [1-2 inch width recommended], 15-20 foot recall leash, and treat pouch w/treats to each session. Harnesses and retractable leashes are typically not adequate tools for dog training. Please contact info@jpdogtraining.com if you have questions.

HANDLERS: Each dog must have at least one consistent handler throughout the entire course.

MEDIA CONTENT: Pictures and/or videos may be taken during the course of the training, for use on the JP Dog Training website, social media, or for advertising purposes.

CUSTOMER RELEASE/WAIVER

I have enrolled myself and/or my dog in dog training classes, private consultations, workshops or other related activities (classes) offered by JP Dog Training, LLC (“JP”).

ACKNOWLEDGEMENTS

*Please read the following acknowledgements carefully as they contain legal obligations and waivers of rights. All boxes must be checked in order to submit this form.

Customer(s) certifies and acknowledges that there is always some unavoidable risk of injury involved when working with animals, especially animals with behavioral issues.

Customer(s) certifies and acknowledges that participation in any of these activities is not without risks such as tripping, falling, getting knocked down and jumped on, bitten, scratched, etc.

Customer(s) certifies and acknowledges that dogs can be inherently difficult to control and that not all dogs will be under control at all times resulting in the possibility of injury to Customer(s), Customer(s)’ dog, Customer(s)’ family members, or third parties.

Customer(s) understands that due to the way that dogs interact with one another, cuts or scratches can occur to Customer(s) or Customer(s)’ dog, even though the dogs are carefully supervised.

Customer(s) certifies and acknowledges understand that JP is relying on representations made by Customer(s) that Customer(s)’ dog(s) is in good health and has received the necessary vaccinations (or equivalent alternatives) as agreed suggested by a veterinarian.

Customer(s) certifies and acknowledges that Customer(s) has had full opportunity to discuss all concerns Customer(s) has about the foregoing risks with JP and its authorized representatives.

Customer(s) certifies and acknowledges that Customer(s) has also made all inquiries and investigations to my satisfaction related to such risks, including, but not limited to, an examination of the training area (if applicable).

Customer(s) acknowledges that some programs are not appropriate for all dogs. JP reserves the right to remove or refuse a dog from any Classes and refund to Customer(s) all or a prorated portion of Customer(s)’ fee.

Customer(s) acknowledges that if Customer(s) dog is to be boarded overnight at any kennel facility selected by JP and/or Customer, JP or representatives of JP will not be responsible for any damage to the kennel, any third parties, or to Customer(s)’ dog or other dogs harmed by Customer(s) dog while boarded at the Kennel.

MEDICAL CARE WHILE UNDER TRAINING*

If my dog becomes injured or ill while in the care, custody or control of JP, JP shall have the right to call my veterinarian as designated on Emergency Medical Treatment Form. In the event of an emergency and my designated veterinarian is unavailable, JP has the right to take my dog(s) to the nearest animal hospital for immediate care. I agree to reimburse, in full, JP for any medical expenses accrued while under the supervision of JP. JP will not be held responsible for any decisions made by the veterinarian on the dog’s behalf. I also agree to release, hold harmless, and indemnify JP from any and all claims arising out of or related to the medical care provided to my dog, including injury, disease, or death.

RELEASE AND WAIVER*

Customer(s) accepts and assumes, without reservation, all risks arising out of or related to participation in the Classes, including, but not limited to: the risks of any and all injuries to Customer(s), Customer(s)’ dog and any of Customer’s family members or third parties who may attend; the risks that Customer(s)’ dog may cause injury to other persons and/or dogs while training, and any and all risks arising out of or related to the property location where any Classes shall take place. In consideration of participation in the training offered by JP, Customer(s), and Customer(s) heirs, executors, administrators, legal representatives, successors and assigns waive, release, discharge and agree not to sue and to indemnify, defend and hold harmless JP and their members, managers, agents, and employees from any and all injuries, losses, claims and damages to any person or persons of any nature whatsoever, including claims arising from the JP’s own negligence, and all costs associated with any such claim, including attorney’s fees, court costs and consultant fees, arising from Customer(s)’ participation in the Classes. This Waiver of Liability & Informed Consent Release shall be legally binding on Customer(s). Should Customer(s) assert a claim to the contrary to what has been agreed to in this Waiver of Liability and Informed Consent Release, Customer(s) shall be liable for all expenses (including attorney’s fees, court costs and consultant fees) incurred by both Customer(s) and JP. No waiver or modification of any provision contained in this Agreement shall be valid unless expressly agreed to in writing by both JP and Customer(s). SEVERABILITY: Every provision herein is intended to be severable. If any one or more of the provisions herein is found to be unenforceable or invalid, that shall not affect the other terms and provisions hereof, which shall remain binding and enforceable. CHOICE OF LAW AND VENUE: This Agreement shall be construed under the laws of the State of Texas without regard to choice of law principles and venue for all disputes arising out of or related to this Agreement shall be exclusively in the Courts located in Austin, Travis County, Texas. DISPUTE RESOLUTION: The Parties, while not anticipating any particular problems during the business relationship wish to outline a way to resolve any disputes that may arise between them regarding this Agreement, including disputes arising out of or related to this Agreement and any Classes in which Customer(s) participates. All claims, disputes, controversies, or disagreements of any kind whatsoever including any claim arising out of, in connection with, or related to this Agreement, including any claim that may arise between Customer and any of JP’s, officers, workers, managers, owners, agents, or clients/customers in their capacity as such, shall be subject to the following alternative dispute process: A. Informal Mediation: Upon a request from any party to this Agreement, the parties shall promptly meet to discuss the dispute and attempt to negotiate a resolution of the dispute. B. Mediation before a Mediator: If the parties are not able to achieve a resolution of the dispute within 30 days of the meeting or 30 days after request for a refused meeting, the parties agree to appoint a neutral mediator and attempt to resolve the dispute through mediation with a private mediator in Travis County, Texas. The parties agree to use reasonable efforts to select a mutually acceptable mediator each party shall be responsible for their portion of the mediation fee. The parties agree to conduct the mediation within 60 days of their meeting (or 30 days after request for a refused meeting) referenced above. If mediation fails, either party may sue in a court of competent jurisdiction consistent with this Agreement.

SIGNATURE*

JP DOG TRAINING INTAKE FORM

BEST OF DENTON COUNTY