Name (required)

Address

City

Your Phone Number(required)

Your Email (required)

Were referred by someone? If so, please tell us who so that we can thank them!

Dog Name

Dog Breed

Dog Age

Sex: MaleFemale

Spayed or Neutered? YesNo

Is your pet up to date on vaccinations? (Copy of records is required): YesNo

Has your dog ever bitten a person or another dog? YesNo

If yes, please explain:

Has your dog ever growled, showed teeth or lunged at a person or another dog? YesNo

If yes, please explain:

Has your pet had any previous obedience training? YesNo

If yes, what level?

Has your pet demonstrated any aggressive behavior?

NoPeopleOther AnimalsBoth

If yes, please explain:

What goals and expectations do you have for your dog's training?

What do you love most about your dog?

I understand and assume all risk associated with participating in this training class which may include risk to myself, my family members and/or my dog. I agree not to hold Angie Epling or Furever Home Training responsible in the event of injury to myself, my family or my dog. I agree to comply with the instructions and rules of the trainer as it relates to me or my dog’s ability to safely complete this course.

I understand that my dog must be free of all infectious disease and must be current on all age appropriate vaccinations including Bordetella, Parvo, Distemper and Rabies. I acknowledge that it is strongly recommended that all dogs be on a monthly flea preventative.

I give permission to Furever Home Training to use my pet’s photo, taken during training sessions, for educational and promotional purposes in any type of media outlet they choose.

I hereby agree and covenant for myself, my heirs, executors, administrators and anyone else who may claim on my behalf to waive, release and discharge Furever Home Training from any and all claims arising out of or in connection with, or any way related to, this training class.

Electronic Signature

Date: