Nirvana K9 Training Club Registration
Handler Information:
Full Name
*
First Name
Last Name
Preferred Name/Nickname & Pronouns
Preferred Name
Pronouns
Phone Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
Emergency Contact Name & Phone Number
*
Dog's Information:
Name & Breed
*
Name
Breed
Sex & Altered Status
*
Male, Neutered
Female, Spayed
Male, Intact
Female, Intact
Weight:
*
Training Background:
Has your dog had any previous professional training?
*
Yes
No
If yes, explain:
*
What tools does your dog currently work on? (Check all that apply)
*
Flat collar
Prong
Slip
E-collar
Harness
Behavior & Safety Disclosure:
Has your dog ever bitten a person?
*
Yes
No
If yes, explain:
*
Has your dog ever attacked or injured another dog?
*
Yes
No
If yes, explain:
*
Is your dog reactive to:
*
Dogs
People
Children
Bikes
Wildlife
Can your dog be safely handled by another adult if needed?
*
Yes
No
Training Goals & Club Intent
What are your top 1-3 training goals right now?
*
What would make club sessions a win for you and your dog?
*
What skills are you most interested in working on? (Check all that apply)
*
Obedience
Nuetrality
CGC Prep
Pack Walks
Reactivity
Drive Building
Scent Work
Handler Mechanics
Filming & Media Consent
Do you agree that other members may NOT film your dog without your consent?
*
Yes
Do you consent to being filmed by the club host (Sami) for educational and promotional purposes?
*
Yes
No
I understand that footage may be posted on social media or used for marketing:
*
Yes
How did you hear about Nirvana K9 Training?
*
Anything else the trainer should know about your dog?
*
What size t-shirt do you wear?
The first 10 club members will receive a free Nirvana K9 T-shirt!
Submit
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