Dog Training Class Registration Form

Group Class Registration Form

Class Name

Preferred Meeting Days and Times

List the days and times you prefer the class meets, for example, Monday, 6pm.

Owner Information

Client/Handler Name

First NameLast Name

Second Client/Handler Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState

Zip Code

Phone Number

Area CodePhone Number

Are text messages ok?

E-mail

Dog Information

Dog's Name

Dog's Date of Birth, Age

example: 1/12/12, 6 years

Dog's Breed/Mix

Dog's Weight:

Gender

Is your dog spayed/neutered?

Age when spayed/neutered?

Where did you acquire your dog?

Shelter, Breeder, etc.

At what age did you acquire your dog?

History & Behavior

PLEASE NOTE: You must provide proof of vaccinations before your dog is allowed in class. Vaccinations: My dog is current on age-appropriate rabies, distempter & parvo vaccinations (titer tests are accepted for adult dogs):

Veterinarian name/clinic

Veterinarian phone #:

Describe any current health conditions, sensitivities, fears or other conditions we should be aware of:

List any specific behavior issues you are having (jumping, barking, etc.)

In order of importance, list what would you like to accomplish with training?

Begin each item with a 1., 2., or 3.,

List at least 3 of your dog's favorite things (specific treats, toys, walks, a person, etc.)

Begin each item with a 1., 2., or 3.,

Has your dog ever bitten a person, another dog, or any other animal?

Date(s) of Bite(s)

Please describe the situation(s) and extent of any injuries:

Is there anything else you think would be helpful for us to know before starting class?

Please tell us how you found out about Coos Canine Academy

Training Services Agreement

Rates

Rates for group training are $110 per dog for most eight week classes or $30 per each one-hour session. Rates for private in-home consultations/training are $100 per initial consultation and $65 per follow-up session.

Payment

Payment methods accepted are cash, check, money order, major credit card, or PayPal. If a check is returned for non sufficient funds, you will have 7 days to submit alternative payment and will be charged any additional bank fees incurred by Coos Canine Academy.

For all training options, payment is due in full on or before the first session.

Cancellations and Refunds

If the minimum enrollment for the class is not met prior to the first session, the class will be cancelled or postponed. We will notify you at least 1 day before the class is scheduled to see if you would like to enroll in an alternate class, receive credit towards a future class, or receive a full refund.

We will refund your class fee if you notify us with the request in writing at least 72 hours prior to the first class session (any enrollments within 72 hours of the start of the class are not eligible for refunds for any reason). To cancel please call us at 573-673-5372 or email us a cooscanineacademy@gmail.com. With 72 hours notice, your cost of class will be fully refunded or you can choose to apply it to further training.

For refunds on payments made via credit card, a credit card processing fee of 3% will be deducted.

Attendance

We are not able to accommodate make-up classes for sessions that you miss, but if you miss a session, your instructor will contact you to discuss what was covered. Students must attend the first session in order to continue with the class. Registration fees will not be refunded for students who miss the first class.

Declines and Referrals

In order to protect all participants in a class, we reserve the right to decline entry to any dog that presents behavior issues that may be dangerous, disruptive, or exacerbated by participation in a group class. If behavior issues are discovered during the class and the instructor determines that it is in everyone’s best interest for you to seek a private trainer, you will be provided with a qualified trainer referral and a refund.

Children

We encourage family members to come to training classes with the handler. The following guidelines must be followed with regard to children attending our dog training classes:

Handlers must be at least 14 years of age.
Handlers younger than 18-years-old must be accompanied by an adult.
Children must be at least 5-years-old to attend the class.
Parents must supervise their children during the entire class.

Liability Waiver

Submitting your application, signifies your agree to our Agreement To Hold Harmless, Waiver And Assumption Of Risk waiver

Agreement To Hold Harmless, Waiver And Assumption Of Risk - I understand that attendance of a dog training class is not without risk to myself, members of my family, guests who may attend, or my dog, because some of the dogs to which I will be exposed may be difficult to control and may be the cause of injury even when handled with the greatest amount of care.

I hereby waive and release COOS CANINE ACADEMY hereinafter referred to as the Training Organization, its employees, officers, members and agents from any and all liability of any nature, for injury or damage which I or my dog may suffer, including specifically, but not without limitation, any injury or damage resulting from the action of any dog, and I expressly assume the risk of such damage or injury while attending any training session, or any other function, of the Training Organization, or while on the training grounds or the surrounding area thereto.

In consideration of and as inducement to the acceptance of my application for training membership by this Training Organization, I hereby agree to indemnify and hold harmless this Training Organization, its employees, officers, members and agents from any and all claim, or claims by any member of any family or any other person accompanying me to my training session or function to the Training Organization, or while on the grounds or the surrounding area thereto as a result of any action by any dog, including my own.

I have read the above contract and agree to all terms and conditions. By signing, you agree to the terms and conditions set forth in the Training Services Agreement:

Date