Basic Manners Registration & Release Form
Please complete this form carefully and entirely.
Legal Owner
*
First Name (or organization's name)
Last Name
Owner E-mail
*
example@example.com
Owner Phone Number
*
By checking each item below, Owner agrees to each statement regarding the herein described dog:
*
I am the legal owner of this dog.
I am at least 18 years of age.
I assume full financial/moral/legal responsibility for the past, present, and future action of this dog.
I, my heirs, executors, administrators, legal representatives, successors and assignees hereby waive, release, discharge and agree not to sue and to indemnify, defend and hold harmless: instructor (Katenna Jones), her business (Jones Animal Behavior), and host (Double Play) of any and all injuries, losses, claims and damages to any person or persons of any nature whatsoever, including claims arising from the Released Party's own negligence, and all costs associated therewith, including attorney's fees, court costs and consultant fees, that may occur.
I hereby indicate electronic acceptance of this agreement.
By checking each item below, Owner agrees to each statement regarding the below described handler:
*
Handler is at least 18 years of age.
Handler is physically capable of keeping this dog safely under control.
Handler will prevent this dog from coming within 6ft of any other student dogs.
Handler will refrain from verbally or physically correcting ANY dog in any way, at all times (including but not limited to scolding, spanking, yanking collar/leash, etc.).
Handler (if different from Legal Owner)
First Name
Last Name
Handler E-mail
example@example.com
Handler Phone Number
Names & ages of any additional humans who may be attending.
Handler agrees to ensure that any minor children who may be attending with me will be prevented from: interacting with, touching or distracting any dog and from disrupting class.
*
I Agree
Dog's Name
*
Dog's Breed(s)
*
Dog's Age
*
Dog's Sex
*
Please Select
Spayed Female
Neutered Male
Intact Female
Intact Male
Unknown
By checking each item below, Owner agrees that the statement is true of this dog to the best of their knowledge:
*
This dog has not displayed aggressive, reactive, or otherwise potentially dangerous behavior toward any human or dog.
This dog is spayed or neutered.
This dog is current on all required vaccines.
This dog is house trained.
Upload Proof of current rabies, DHLPP (parvo combo), and Bordatella (kennel cough) vaccines
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(if you are unable to upload, please send a copy to info@jonesanimalbehavior.com prior to course start date)
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