Name *

First Name

Last Name

Co-Owner Name (If Applicable)

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Have you moved with your dog within the last 12 months?

Yes

No

Have you added or lost any pets within the last 12 months?

Yes

No

Have you added or lost any family members within the last 12 months?

Yes

No

Dog's Name

First Name

Last Name

Is your dog up to date on their rabies vaccination? *

Yes

No

Under 4 months

Dog's Sex

Male

Female

Is your dog fixed?

Yes

No

Too Young

Does your dog have a crate?

Yes

No

What type of learner are you?

Visual

Audible

Kinesthetic

Agreement of Release & Waiver of Liability *

By checking "I agree" below, I hereby have reviewed and agree to the following: 1. I represent and warrant that my dog(s) is physically fit and has no medical conditions that would prevent their full participation in any training class. I agree to have my dog(s) clean and free of fleas and parasites before the first training along with proof that my dog(s) are up to date on all vaccinations. These vaccinations are to remain current throughout the duration of trainings. 2. In consideration of my dog(s) being permitted to participate in training, I agree to assume full responsibility for any risks, injuries or damages, known or unknown, to third parties, which might incur as a result of my dog(s) participating in training. 3. In further consideration of my dog(s) being permitted to participate in training, I knowingly, voluntarily and expressly waive any claim I may have against Meghan Prague for injury or damages, which my dog(s) or I may sustain as a result of participating in training classes. 4. I hereby waive and release Meghan Prague of any and all liability of any nature or damage which I or my dog(s) may suffer, including specifically, but not without limitation, any injury or damage resulting from action of any dog(s), and assume risk of any such damage or injury while attending any training session held by Meghan Prague. 5. I, my heirs or legal representatives forever release, waive, discharge and covenant not to sue Meghan Prague for any injury or death caused by her negligence or other acts during the training of my dog(s) or while on your premises or any surrounding area thereto. 6. If Dog(s) causes property damage, or bites or injures any dog(s), animal(s) or person(s) who is a third party to this Agreement, during or after the term of this Agreement, then Client agrees to pay all resulting losses and damages suffered or incurred to the third party. 7. Meghan Prague reserves the right to refuse service to anyone. You can make your payment to Meghan Prague by check (or pay in cash) by the first day of training. Children under the age of 18 years must be accompanied by an adult. Junior handlers must be at least 10 years old. 8. We allow two rescheduled appointments. All packages must be completed within a 7-week time frame. All sessions completed after 7 weeks of the start of training will be charged an extra $90 per session. 9. The class payment is non-refundable and upon a returned check from the bank for any reason I agree to pay a $25.00 returned check fee. 10. Any photographs taken by Meghan Prague of you and/or your dog(s) during training is the property of Meghan Prague and can be used on her web-site, advertising or marketing publications.

I AGREE