Your Name

Day Phone

Evening Phone

Street Address

City Zip

Email

Dog's Name

Spayed or Neutered  yes no

Dog's Age

Breed (purebreed or best guess!)

Veterinarian

Please tell us your concerns, comments, questions or any other important information about your dog:

Please tell us about your training goals and expectations:

Has your dog ever shown aggression?

 no lunging growling baring teeth snapping biting

In consideration of and as a prerequisite to the acceptance of my application, I/we,hereby release Purely Positive Dog Training, LLC, Susan Marett, class instructors and assistants, employees, including those owning or working for the physical facility where lessons are conducted, from any claims of damage or liability including attorney’s fees, medical payments, property damage, or bodily injury damages. I further assume full responsibility for any injury that may occur to another person or their dog or dogs because of my actions or those of my dog or dogs.

I/we also agree that I am assuming the risk of participating in training where there are other dogs whose temperament is unknown to me. I/we assume full responsibility for any injury that may occur to me, to my dog or dogs, or other property, or any damage that would ordinarily be due me. Therefore, I waive any right that I may have to institute any suit or other proceedings to recover therefore.

By signing this document, I/we agree to pay the fees set forth by Purely Positive Dog Training, LLC and further agree that fees are not refundable except in the case of serious illness of owner or dog that precludes training, or death of owner or dog, or the rehoming of the dog. I also agree that no lesson cancelled less than 24 hours prior will be made up or rescheduled. Finally, I agree that I have one year from the day this waiver was signed in which to schedule prepaid lessons.

Electronic Signature:

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