Class Sign Up Form – Waiver

Class Type

Class Date

Name *

First

Last

Address

Cell/Mobile Phone *

Other Phone

Email *

Dog Name *

Breed *

Age *

Weeks, Months or Years *

Gender *

Weight *

Spay/Neuter *

Description of behaviors and goals for your dog.

Does your dog have his/her Canine Good Citizen (CGC)? *

Is your dog friendly with people? *

Is your dog friendly with other dogs/animals? *

If you have answered 'No' to either of the two questions above please explain.

Vet Organization Name *

Doctor Name *

Where did you Purchase/adopt your dog from? *

How did you hear about our service?

May we use photos for Facebook/Marketing? *

Comments/Questions

Waiver

Waiver, Assumption of Risk and Agreement to Hold Harmless I understand that attendance at a dog training class is not without risk to myself, members of my family, or guests who may attend, or my dog, because some of the dogs to which I (we) 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 Hearts for Paws Dog Training, its officers, employees, owners, members, contractors, and agents from any injury or damage resulting from the action of the dog, and I expressly assume the risk of any such damage or injury while attending any training session, 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 I hereby agree to indemnify and hold harmless Hearts for Paws Dog Training, its officers, employees, members, contractors, and agents from any and all claims, or claims by any member of my family or any other person accompanying me to any training session or while on the grounds or surrounding area thereto as a result of any action of any dog, including my own.   Refund Policy: because we keep our classes small, we are unable to issue refunds or class credits.   Terms of Service   1. The information filled out on the class application is accurate and complete. 2. All owners must clean up after their dogs when on the premises of the facility. 3. All dogs must remain on leash when on the premises of the facility 4. Any dog which, in the opinion of the class instructor, is aggressive, will be removed from the class. 5. Anyone under 18 training a dog in class must have a parent or responsible adult in attendance during class.

By typing/signing my name below, I agree to the above agreement and terms of service. *

Name