MINNESOTA K-9 SOLUTIONS

Canine Behavior & Obedience Training Program

Application

Please Print Clearly

Owner's Name:______

Address:______

City: ______State: ______Zip: ______Phone:______

E Mail Address______

Dog Breed: ______Pet's Name: ______Age:______M/F

The training in which you will be attending, can be completed on the training log as you go. You will be provided with a training log after you sign up..

Starting Date: ______Time: ______

Who were you referred by:

What are your expectations or goals for your dog?

______

______

STEP ONE:

All classes are $20.00 per1-hoursession. A one-time $40.00 Behavioral Assessment is required in order to reserve future training sessions. After completing this application, copy and paste it as a word document and e-mail it as a word document attachment to

STEP TWO:

After E-mailing your application, Mail a Check or Money Order For $40.00 Made Out to Minnesota K-9 Solutions LLC. Rod Bombalier will call you to arrange a day for your dog’s Behavioral Assessment. Our Mailing address is:

Minnesota K-9 Solutions

10761 Bush Lake Road Circle

Bloomington Minnesota 55438

Due to the limited amount of private training slots, and the low costs involved, we do not provide refunds

Release of Liability and Hold Harmless Agreement

By signing this release, I acknowledge and understand the intent of the training services provided I hereby agree to absolve and holdharmless Minnesota K-9 Solutions, their agents, officers, owner, and staff trainer Rod Bombalier and any other parties connected with the services being provided in anyway, singly or collectively, from and against any blame and liability for any injury, misadventure,harm, loss, negligence, wrongful death, inconvenience or damage of property hereby suffered or sustained as a result of participation in the training services or any actions therewith. I hereby consent to and permit emergency treatment forillness or injury and assume all financial obligations resulting there from.

Signature: ______Date: ______

Print Name: ______

Signature of Parent (if under 18 years of age): ______