Group Class Registration

GROUP CLASS REGISTRATION

Complete this form and email it as an attachment to or mail with your check to At Your Service, PO Box 61, Wendell, MA 01379.Checks are made out to “At Your Service.” See our website for the dollar amount for the class.

Owner name:______

Mailing address:______City/State/Zip:______

Primary phone: ______Secondary phone: ______

Email: ______

Best way to reach you on short notice (e.g., snow cancellation, etc.)? ______

Name & start date of class you are registering for: ______

How will you pay (check one): __online by credit card invoice __ with acheck(by mail)

How did you hear of At Your Service? (If referred, please give their name) ______

If other family members will be attending class, please list their names and life stages. If under 18, please give age, as well:

Name:Child/Teen/Adult/Elder?

Does anyone in the family require any disability accommodations? If so, please describe how we may accommodate them:

Dog’s name: ______Breed/mix:______

Approximate weight: ______Date of birth (or approximate):______

Date you acquired the dog: ______Sex: _____ Spayed/Neutered? ______

How did you acquire the dog(breeder/rescue/shelter)?

Health -- Bring current vaccination record to 1st class. We'll contact your vet for questions.

Veterinary clinic: ______Date of last visit: ______

Which vet does your dog see? ______Vet phone: ______

Is dog up-to-date on rabies vaccination? _____ Other vaccines your vet recommends? ______

Doesyour dog have any food allergies? Please list ______

Does your dog have any medical issues we should be aware of? (Describe)

Is your dog very sensitive to certain sounds? If yes, what types of sounds?

Is your dog friendly toward new people?

Describe specifically what your dog does when your dog sees unfamiliar people:

Is your dog friendly toward new dogs?

Describe specifically what your dog does when your dog sees unfamiliar dogs:

Is your dog ever possessive of food, toys, or bones with people? Describe:

Ever possessive of food, toys, or bones with other dogs?Describe:

Has your dog bitten anyone, or has anyone claimed the dog has bitten them? Describe:

Is your dog in training to be a service dog?

Please list any classes the dog has already taken or is currently taking:

Where/which trainer?

Do I have your permission to contact them?

Does your dog know any commands or behaviors already? If so, what?

Is there anything else we should know to make you and your dog welcome in class?

CONTRACT/DISCLAIMER: Read carefully. By initialing and signing, you indicate you agree with these terms.

Liability: At Your Service Dog Training, LLC[hereafter “At Your Service”] will endeavor to create as safe an environment as possible for the training of your dog and will offer only sound, safe, and responsible training and training instructions. However, Client recognizes that At Your Service is not responsible for any unintentional errors, omissions, or incorrect assertions. Further, Client is and will remain responsible for the actions of Client’s dog at all times and hereby agrees to indemnify and hold harmless At Your Service of any and all claims of injury, expense, costs, or damages caused by the actions of Client’s dog while under At Your Service’sinstruction or control and under my own care as a result of following training instructions. Client acknowledges and understands the inherent risks of owning a dog or training a dog as a therapy/service dog, including but not limited to the risk of dog bites to Client or others, needing to rehome or career-change a dog not suited to work as a service or therapy dog, and any attendant emotional or physical distress or injury resulting from raising/training a dog.

Initial: _____

Service, Emotional Support, and Therapy Dogs – No Warranty or Guarantee:While At Your Service endeavors to support Client in acquiring or training a dog/puppy that meets Client’s goals and preferences, Client recognizes that animal behavior is unpredictable and that animals may develop unforeseen health or temperament problems, or turn out to be unsuited to Client’s expectations or goals. Client agrees that At Your Service offers no guarantees, nor implied or expressed warranties that animals that Trainer assesses, recommends, or trains will meet Client’s assistance, training, behavior, pet, or working goals.

Initial: _____

No Cancellation Policy: Client and At Your Service share the same goal: better behavior for Client’s dog. Consistency and continuity are required for training and behavior modification. To support these goals, At Your Service maintains a NO CANCELLATION policy. If Client chooses to cancel, Client’s lesson is forfeited. Lessons may be rescheduled at the discretion of the trainer. Trainer may also offer to train Client’s dog in Client’s absence, if safe and appropriate.

Initial: _____

GROUP CLASSES:Client understands that group classes are not appropriate for all dogs. Client has provided At Your Service with accurate information to the best of their ability about Client’s dog and dog's habits, health, behavior, and training. However, Client understands that, at the discretion of the instructor, any dog or team may be removed from class. When possible, At Your Service will offer a private training session in the place of the balance of that course. Reasons a dog and handler team may be removed from class include but are not limited to: excessive barking, potentially unsafe around other dogs or people in the evaluation of the instructor, or not sufficiently in control by the handler during class. At Your Service does not offer refunds.

Initial: ____

Products & Services:Client understands that the recommendation of any product or service is not a guarantee of Client’s satisfaction with that product or service. Client understands that training services (day training and lesson packages) are good for a period of one year from commencement of services. Unused services are forfeited and cannot be transferred to other people or used for other services. Payment for private lessons cannot be used for group classes, and vice-versa.

Initial: _____

Media Permissions:Client and Client’s dog may be videotaped during lessons or consultations. Videos or recordings which capture or record Client’s name, likeness, image, voice, or appearance may be posted to allow Client and At Your Service to share information to support the training of Client’s dog. Pictures and videos of Client’s dog taken by At Your Service or shared by Client to At Your Service, as well as Client’s written communication about Client’s dog to At Your Service may be used by At Your Service on its website, promotion, publicity, or other materials, with the dog’s name and city.

Initial: _____

Signature

This contract is validated by the signatures below in total and as approval for future services without additional written authorization.

______

Client/Dog ownerDate