Group Class Registration & Release Form
Please complete this form carefully and entirely for each dog.
Legal Owner
*
First Name (or organization's name)
Last Name
Owner E-mail
*
example@example.com
Owner Phone Number
*
Format: (000) 000-0000.
Which class are you registering for?
*
Basic Manners
Beyond Basic Manners
Intro to Leash Skills
By checking each item below, Owner agrees to each statement:
*
The above indicated person is the legal owner of this dog.
*
The above indicated owner is at least 18 years of age.
*
The above indicated owner assumes full financial/moral/legal responsibility for the past, present, and future action of this dog.
*
The above indicated owner, their 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.
By checking each item below, Owner agrees to each statement regarding the person who will be handling the dog during class:
*
Handler is at least 18 years of age.
*
Handler is physically capable of keeping this dog safely under control and at least 6 ft away from other dogs at all times.
*
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 agrees to ensure that any minor children who may be attending with dog will be prevented from: interacting with, touching or distracting any dog and from disrupting class.
Handler (if different from Legal Owner)
First Name
Last Name
Handler E-mail
example@example.com
Handler Phone Number
Format: (000) 000-0000.
Names & ages of any additional humans who may be attending.
Dog's Name
*
Dog's Breed(s)
*
If known
Dog's Age
*
(must be over 6mos due to course content)
Dog's Sex
*
Please Select
Spayed Female
Neutered Male
Intact Female
Intact Male
Unknown
Please closely review and check each item below:
*
This dog has never displayed aggressive, reactive, or otherwise potentially dangerous behavior toward any human or other dog
*
This dog can be within 10ft of a stranger or other dog without lunging, growling, continuous barking, staring or leash yanking toward said stranger or dog
*
This dog is over 6mos old
*
This dog is current on all required vaccines.
*
This dog is spayed or neutered.
*
This dog is house trained.
*
Owner agrees ALL above statements are true of this dog to the best of their knowledge
*
Owner agrees that if any of the above statements are found to be inaccurate, dog may be removed from the class at any time without refunded fees.
Upload proof of current , DHLPP (parvo combo), and/or Bordatella (kennel cough) and/or rabies vaccines here
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