Adventure Training Release Form
Client Information:
Client's Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Phone Number
Phone Number
*
Email
*
example@example.com
Dog Information:
Dog's Name
*
Breed
*
Age
*
Sex/Reproduction Status
*
Male, Neutered
Female, Spayed
Male, Entire
Female, Entire
2nd Dog's Name
2nd Dog Breed
Problem Behaviours or Training Issues (if any)
Goals for your dog:
Example: Walk past dogs without barking, loose leading walking, not jumping out of car until released.
How does your dog behave around other dogs?
Example: Excited, fearful, aggressive
Has your dog ever made an attempt to bite another dog or a person?
Yes
No
If the answer is yes, kindly provide further details.
Is your dog possessive when it comes to toys or food?
Yes
No
If so, please elaborate on this behavior.
Has your dog ever been involved in a scuffle with another dog?
Yes
No
If so, please provide additional information.
Are there any medical conditions or health concerns related to your dog that we should be aware of?
Has your dog received any training in obedience?
Yes
No
If so, could you specify the type of classes and the location where they took place?
What does your dog know?
Sit
Down
Stay
Stand
Release an item
Leave it
Recall
Other
Out of 10, how often does your dog listen to commands?
Any other commands they know? Please include any words you use for the above commands.
Example: Spin, Out-For release a toy, Drop-Lie down
Are they crate trained? (We do crate our dogs for safety in the van)
Yes
No
Are they reactive on leash? (Barking at other dogs for example)
Yes, to dogs.
Yes, to people.
Yes, to objects.
No
Out of 10, how good is your dog's recall?
Can you think of any scenarios where they struggle with recall?
Example: When they see people or dogs
Any Food Allergies?
Anything else we should know?
Examples: Triggered by skateboards, doesn't like children, doesn't like men or power tools...
What days would you prefer?
Monday
Tuesday
Wednesday
Thursday
Friday
How many times a month would you require our service?
Weekly
Fortnightly
Monthly
Casually
Can we give your dog treats during the day? We use Prime100 and Ziwipeak
Yes
No (Please provide your own treats)
Is it okay that your dog goes swimming? (We will towel dry them with a towel provided by you on drop off but may still be damp)
Yes
No
Can we upload your dog to our social media?
Yes
Yes, without their name
No.
New clients must complete a "Meet and Greet". This is $60 and will include a 15 minute walk. You need to be home for this and it's your chance to show us how to collect your dog from your home. Which day suits you?
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
How did you hear about us?
Google
Instagram
Bernie's Pet Barn
Ad
Referral
Seen the van
Emergency Contact:
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Phone Number
Veterinarian Information:
Veterinarian Clinic Name and Location
Example: Coastal Veterinary Hospital Bundall
Phone Number
Waiver:
Client's Signature
Date Agreed
-
Month
-
Day
Year
Date
Submit
Should be Empty: