Pet Behavior Help
4925 Eno Woods Trail
Durham, NC 27712
http://www.petbehaviorhelp.com
Class Registration
Your Name ________________________________________
Address ________________________________________
City/State/Zip ________________________________________
Phone (H) ____________________ (W) ____________________ (Cell) ____________________
Email (please write neatly!) _________________________________________________
Age (if under 18) __________________________________
Dog’s Name ________________________________________
Breed ________________________________________
Date of Birth / Age ____________________ Sex ___________ Neutered?__________
Has your dog been to previous classes? Yes No
If yes, where and which classes ___________________________________
Class of choice ___________________________________________
Day / Time ___________________________________________
Alternate ___________________________________________
Day / Time ___________________________________________
Are you interested in daytime classes? If yes, what days and times are you available?
About your dog (If we don't already know you):
Does your dog play with toys? Describe.
Has your dog ever acted fearful? Describe.
Does your dog bark at other dogs or people? Describe.
Has your dog ever growled at dogs or people? Describe.
OVER è
Pet Behavior Help
4925 Eno Woods Trail
Durham, NC 27712
http://www.petbehaviorhelp.com
WAIVER
I understand that attendance at a dog training class is not without risk to myself, members of my family or guests who may attend, or my dog, because I recognize the inherent risks related to participation in the sport of dog agility and because some of the dogs to which I (we) will be exposed may be difficult to control and may be the cause of injury even when handled with the greatest amount of care.
I hereby waive and release Pet Behavior Help, Inc., its officers, employees, members and agents from any and all liability of any nature, for injury or damage which I or my dog may suffer, including specifically, but without limitation, any injury or damage resulting from the action of said dog, or any other dog, and I expressly assume the risk of any such damage or injury while attending any training session or other function of the center, or while on the training grounds or the surrounding area thereto.
In consideration of and as an inducement to the acceptance of my application for training or attendance by my dog(s) and/or me at any function at this center, I hereby agree to indemnify and hold harmless Pet Behavior Help, Inc., its officers, employees, members and agents from any and all claims by any member of my family or any other person accompanying me to any training session or function of the center or while on the grounds or surrounding area thereto as a result of any action by any dog, including my own, or for any other reason.
I have read and agree to abide by the policies of Pet Behavior Help, Inc. as detailed on the web site and summarized below:
1. Dogs must be on-leash and under control at all times
2. All dogs must have proof of vaccinations and a signed waiver on file before participating in any events
3. All handlers must clean up after their dogs at all times anywhere on the property.
4. No unapproved dog-dog interactions. Every handler must keep his/her dog away from other dogs unless they have specifically asked the other handler if the dogs can interact at that time.
5. Females in heat will not be allowed to participate in the Intro, Starters or Basics class. At the instructors discretion, females in heat will be allowed to participate in advanced classes (Intermed and above) when a trial or event is not scheduled within 2 weeks. The instructor must be informed at least 2 days prior to class. This rule will allow advanced dog/handler teams to proof against this type of distraction with the guidance of the instructor.
6. Any dog that a PBH certified instructor deems to be highly disruptive, unruly or dangerous can be excused from group classes at any time. The handler will be referred to private consultations and a refund for the remaining classes will be given.
7. A full credit/transfer/refund will be given if Pet Behavior Help, Inc. cancels class. If a client cancels class before attending, the client will be refunded the tuition fee minus a $25 processing fee. Refunds for cancellations after classes begin will be prorated and subject to the $25 processing fee.
______________________________________________________________
Printed Name of Owner or Authorized Agent
______________________________________________________________
Signature of Owner or Authorized Agent Date
(Parent or Guardian must sign for minors)