Private Training Intake Form

Owner's Full Name*

First NameLast Name

Owner's Email Address*

example@example.com

Owner's Phone NumberType a question*

Please enter a valid phone number.Format: (000) 000-0000.

How did you hear about us?

Who else lives in your home? (Partners, children, other pets)

YesNo

If Yes to above; when is the expected date of the new arrival?

Date

Dog's Name*

Dog's Breed*

MaleFemaleUnknown

Dog's Age (in years)*

Where did you get your dog from?

How long has your dog been in your home?

Does your dog have any allergies?

Does your dog have any medical concerns?

Please upload proof of most recent vaccinations. Please include Rabies, DHPP Vaccine — (Distemper, Adenovirus , & Parvovirus) and Bordetella. *Please note, due to recent outbreaks of contagious respiratory illnesses, Bordetella is now mandatory to attend in person training classes. If your does not have this vaccine or is not current, please book a vet appointment prior to class start. *

YesNoAt home training only

If yes, please describe the type of training, what you liked most and what you liked least.

Please describe how you handle unwanted behaviors with your dog. (Example: Barking, pulling on leash, jumping, etc.)

Please list all types of collars your dog wears or has worn in the past. (For example: flat, choke, matingail, electric, etc.)

Please list any other training aids you use, or have previously used. (Example: Harness, had collar, muzzle, etc. )

Lunging, growling snapping at a dog or person?Biting a dog or person?Showing aggressive displays towards a dog or person (baring teeth, fixating, barking)Done any damage to another person or dog that did or did not require medical care?Guarding items, people, food, or spacesOther

Please expand on any of the above behaviours.

What made you contact Pawsitive Families? What are your Training Goals and Objectives*

I give permission for video and/or picture image(s) of myself, children, and my dog(s) to appear on public forum(s)

Any Special Requirements or Concerns

Additional Comments or Information

LIABILITY WAIVER AND RELEASE

Pawsitive Families Education & Training will strive to create a safe environment as possible for the training of my dog and will make every attempt to offer only sound, safe and responsible training and training instructions.

However, I agree that Pawsitive Families Education & Training have the right to refuse this application for causes that it shall deem to be sufficient. In consideration of the acceptance of the application and the provision of training, I agree to hold the organizations, Pawsitive Families Education & Training including its officers, directors and owners, the premises/property, harmless from any claim or loss or injury which may be alleged to have been caused directly to any person or thing by the act of this/these dog(s) while in or upon any organizations premises, client(s) premises or grounds or near any entrance thereto, and I personally assume all responsibility and liability for any such claim.

I further agree to hold the aforementioned parties harmless from any claim for loss of this dog by disappearance, theft, death or otherwise, and from any claim for damage or injury caused or alleged to be caused by negligence of the parties aforementioned, or by the negligence of any other person, or any other cause or causes.

I hereby assume the sole responsibility for and agree to indemnify and save harmless the aforementioned parties from any and all loss and expenses (including legal fees) by reason of the liability imposed upon by any of the aforementioned parties for damage causing bodily injuries, including death, any time resulting from or sustained by any person or persons including myself or on account damage to property arising out of or in consequence of my participation in any Pawsitive Families Education & Training event, however, such injuries, death or damage to property may be caused or may have been alleged to have been caused by negligence of the aforementioned parties or any of their employees, agents, or any other person.

TRAINING RESULTS

I understand that Kari Joly and Elysia Ostrander (who are recognized to be the Trainers) will make every reasonable effort to help me achieve training and behavior modification goals. I understand that there are no guarantees of my dog’s performance or behavior as a result of providing professional animal behavior modification.

I understand that I, and the members of my household, must follow the Trainer’s instructions without modification, work with my dog daily as recommended and constantly reinforce the training being given to my dog.

I accept that the training method used will involve the use of rewards such as, but not limited too: food, toys, play, physical affection and life rewards.

I recognize that Kari Joly, Elysia Ostrander Pawsitive Families Education & Training are not responsible for any unintentional errors, omission or incorrect declarations.

I further understand that dog behavior is not static and that my dog will not continue to perform even trained behaviors without ongoing practice. This is especially significant in cases involving any type of aggression, where although the dog’s behavior may be modified, the dog is never considered ‘cured’. My dog’s behavior is ultimately my responsibility.

CANCELLATIONS AND REFUNDS

No refunds are given on services that have already been used or prepaid.

Missed classes cannot be rescheduled, unless in a rolling enrollment class with an open spot and only if you and your dog still fall within the parameters of the class prerequisites.

Private lessons cancelled or rescheduled with fewer than 48-hours’ notice will result in a full lesson charge or lesson appointments that are not cancelled at all prior to the training lesson, will be charged a full lesson.

MEDIA RELEASE

There are occasions where Pawsitive Families Education & Training , Kari Joly, or Elysia Ostrander, may video or photographs of you or your dog(s) during a training lesson to be used in various advertising, promotional or education materials.

Audio and/or videotaping of Kari Joly or Elysia Ostrander, Pawsitive Families Education & Training is permitted in general, for the purposes of going back to review the training lesson for private use only unless explicit permission is given by Kari Joly or Elysia Ostrander, Pawsitive Families Education & Training, to use the material elsewhere.

I have read and agree to the Terms above