Dog Training by Lisa Mawson

Canine Culture

Dog Training by Lisa Mawson

At Canine Culture Training Center or other location

Name of family members attending class:______

______

Address:______

City, State and Zip code:______

Contact number(s):______

Email address:______

Dogs Name(s)______

Breed(s):______Sex (intact?)_____

Have you ever attended an obedience session before? Yes or No

With this dog? Yes or No If yes, where?______

Please attach copy of current vaccinations and list your veterinarian.______

Does your dog have any health issues? Yes or No / If Yes, what?______

______

Is your dog on any medications? ______

Does your dog have arthritis or any other orthopedic or spinal issues?______

If Yes, what?______

How does your dog interact or react with people?______

______

With other dogs?______

With children?______

Does your dog have any fear issues? Yes or No

If yes (fear issues) please list what. ______

How does your dog react with strangers, or in unfamiliar locations?______

______

Has your dog ever bitten anyone? Yes or No

Severity______

Number of occurrences______

Waiver, Agreement and Assumption of Risk

I ______, understand that attending the canine obedience training class at Canine Culture, at any location, business, public or private location, is not without possible risk to myself, members of my family that attend, my dog(s), due to dogs that are present during class that may be difficult to control and may cause injury.

I understand that I am responsible for my dog and their actions at any time, whether they are under my control or not.

I ______, hereby waive and release Lisa Mawson and Canine Culture, or any hosting venue, or employees that are present during training sessions from any and all liability for injury to one’s self or dog(s), including, but not limited to, any injury or damage resulting from the action of any dog(s), including my own and I assume the risk of any such injury while attending a canine obedience training class.

I hereby agree to indemnification of Lisa Mawson and Canine Culture, from any and all claims from attendees of training that accompany me to training as a result of any action by any dog, including my own.

I ______understand that cancelation of any classes (excluding severe weather) without reasonable notice (2 business days, excluding weekends and holidays) will result in a $25 cancelation fee or docking ½ hour of class time, at our discretion.

I ______, agree that my dog(s) may be videotaped or photographed, and used for promotion or advertising of Canine Culture dog training by Lisa Mawson.