Street Address Line 2
State / Province
Postal / Zip Code
Name of dog(s)
Age/breed/sex of dog(s), and any relevant medical information?
Allergies, medications, spayed/neutered, health issues/physical injuries (past or present), blind/deaf, etc.
Rabies, Distemper, Parvo, Boardatella, etc
How did you hear about me?
Please specify any personal references.
What services are you interested in?
board & train program
daily walks & fulfillment
Days & times available for sessions?
Training & Behavior
Have you taken classes or worked with other trainers previously?
Goals & expectations for training?
Describe any training issues or behavior concerns you have with your dog?
Describe a typical day for your dog(s)?
What type of exercise does your dog get, and when? How much/how often? Other daily habits or patterns? Do you have a fenced in yard? Doggy door? Where does your dog sleep at night?
Describe your current feeding routine?
What do you feed your dog, and how often? Do you free feed or require the dog to wait/perform obedience/tricks/etc? Do you feed in a crate? Do you use interactive food puzzles or toys? Does your dog guard food?
Describe a walk with your dog?
Is your dog crate trained?
When is your dog crated?
when not home
no longer use the crate
occasionally when at home (during meals, if guests arrive, etc)
Photo & Video Release
yes, I permit Easy Dingo to take pictures or video of my dog for informational, educational, or advertising purposes in regards to dog training.
no, I do not want myself, my family, or my dog in any video or pictures.
Easy Dingo has no prior civil, insurance, professional or personal claims in regard to any animal training or animal related disputes. To date, an entirely clean occupational, criminal, and insurance/liability record is sustained, as well as occupational insurance and bonding. I hereby acknowledge that I have voluntarily applied to participate in dog training activities with Easy Dingo. I am aware that there are inherent risks and hazards involved in activities with and around dogs, and I am voluntarily participating in these activities with knowledge of potential dangers. I am aware that any dog, regardless of training, handling, or environmental circumstance, is capable of biting and I expressly acknowledge the risks therein. In order to participate in dog training classes or other activities, I, being fully informed of such risks and hazards, agree to assume all risks of such occurrences. I hereby waive any and all claims or actions that I or my guardians or representatives may have, from any and all personal injury to myself, my dog, children in my charge, or harm to property or person caused directly or indirectly, through action or inaction of self or others, by acts that might occur in dog training classes, any other format of training activities or secondary training without trainer present or engaged. I agree to indemnify Easy Dingo from any and all claims by myself, member of family, or any agent while within training facilities, within my home property, or in the general public as a result of any action or inaction, of either my dog or any other. I also agree to assume sole responsibility for injury or damage caused by myself, children in my charge, or by the dog I own or handle and further agree to indemnify, defend and hold harmless the instructors, trainers, or assistants from and against property damage, loss, liability or expense, including legal cost and attorney’s fees, which result from damage caused by myself, children in my charge, or by the dog I own or handle. I have provided current vaccination documents from a licensed veterinarian. I understand that anytime dogs are exposed to other dogs that there is a potential for disease transmission. The benefits from interactions with other dogs far outweigh the dangers of transmission. I will not hold Easy Dingo, the instructors, trainers or assistants accountable for any communicable disease. I have read the policies for dog training and I agree to adhere to them.
Should be Empty: