Training Registration Owner Information Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Email * Dog Information Dog Name Dog Breed Dog Age Dog is: Intact Male Neutered Male Intact Female Spayed Female Veterinarian Information We will need a copy of your dog’s veterinary records. You can text us at 352-278-7404 or email to us at Victoria@HeartSoulK9.com. Vet Clinic Name * Vet Phone * (###) ### #### My dog is current up to date with: * De-worming Flea & Tick preventative Bordetella (kennel cough) vaccine Rabies vaccine Distemper/Parvo vaccine Known medical issues & medications: Food & Medications You supply your dogs food and medications. What kind of food & how many cups per day? What kind of medications/supplements per day? Behavior Issues I am interested in... * Companion/pet dog training Behavior modification & rehabilitation Service Dog training Board & Train Program Day Training Private Training Sessions Online School Other My dog... * Check all that apply. Has no discernible issues. Does not obey commands. Has never been trained before. Is not house-trained. Has gotten into a dog fight. Growls/barks/lunges at other dogs. Growls/barks/lunges at people/children. Has broken skin on another dog. Has broken skin on a human. Does not let me touch feet/nails. Does not let me put on/remove their collar. Does not go into the crate. Barks/growls in the crate. Reacts undesirably to touching/petting. Has separation anxiety. Eats poop. Is aggressive when approached. Is aggressive around food. Is aggressive when I try to take away food. Growls when I try to get him/her off furniture. Has accidents in the crate/house. Chases small animals. Has injured or killed small animals. Is crate trained. Jumps fences. Destroys bedding. Destroys toys. Anything to add about your dogs behavior? General Waivers Heart & Soul Dog Training, LLC will endeavor to create as safe an environment as possible for the training, boarding, care, custody and control of the dog(s) identified above (hereinafter the “Dog”), and will offer only sound, safe, and responsible training, care, and post-training instructions. Owner agrees that any animal may exhibit unpredictable behaviors and that Heart & Soul Dog Training will not be liable for the actions of the Dog that are outside the control of Heart & Soul Dog Training. Owner agrees that the recommendation of Heart & Soul Dog Training of any product or service is not a guarantee of performance or Owner’s satisfaction with that product or service. Owner acknowledges and agrees that owning any animal, including the Dog, has inherent risks, including but not limited to the risk of dog bites to Owner, people, animals. Owner is responsible for the cost of any veterinary care and insurance deductible required during the time the Dog is engaged in the program. Owner is also responsible for the cost of any veterinary care that may be required subsequent to the boot camp program for injuries or ailments that may have occurred during the boot camp program. Owner fully understands the tools and techniques that are used to train and modify the behavior of their Dog and agrees to the tools and techniques which include, but are not limited to, the following: prong collar, bark collar, remote training collar, slip lead, pet convincer, muzzle, flat buckle collar, gentle leader, martingale collar, dominant dog collar, essential oils, kinesiology tape, bonkers. Owner will follow all instructions for equipment and will not leave equipment on Dog while unattended or overnight. Owner agrees that, although the trainers will provide instruction and equipment for the training of Dog, owner is responsible for maintaining control of Dog and is responsible for the successful training, control and conduct of Dog at all times. This Service Agreement covers the relationship between Owner and Heart & Soul Dog Training each time owner receives services from Heart & Soul Dog Training. Owner affirms the terms of this Service Agreement and the truthfulness and accuracy of all statements owner has made regarding Owner and Dog/s. You (the Dog Owner) acknowledge and understand that there are certain risks involved in dog training, boarding and care. You hereby release and agree to hold Heart & Soul Dog Training, its owners, employees, family, guests, visitors, associates and agents harmless from any and all manner of injuries or death, damages, claims, losses, liabilities, costs or expenses, causes of action or suits, whatsoever in law or equity (including, without limitation, attorney’s fees and related costs) arising out of or related to any services provided by Heart & Soul Dog Training, its owners, employees, associates or agents, even under terms and situations of gross neglect. Services will not be provided by Heart & Soul Dog Training without your complete agreement with the Service Agreement. Your signature conveys you understand and agree to all content and conditions specified within the Service Agreement. Terms and conditions of this Service Agreement may not be changed or updated. You are solely responsible for any expenses attributed to your Dog’s destructive or aggressive behavior. Further, by entering into this agreement, you agree to indemnify, defend, protect and hold Heart & Soul Dog Training, its owners, employees, associates and agents harmless from and against any and all damages, claims, losses, costs, liabilities or expenses (including, but not limited to, injuries to any person/animal or destruction of any property) arising out of your dog’s behavior, regardless of whether or not your dog has exhibited such behavior in the past or the actions or inactions of Heart & Soul Dog Training, its owners, employees, associates or agents. If Dog is aggressive, you will use a muzzle during all training sessions and are responsible for avoiding potentially problematic situations. As a force majeure, in case of (1) unforeseeable event, (2) outside of the parties’ control, that (3) renders performance impossible or impractical, Heart & Soul Dog Training will do our best to continue training your dog. This may mean moving to virtual video training sessions. Service Dog Waiver Not every dog has what it takes to be a service dog. During our Service Dog Training Program, we will train your dog and evaluate your dog for service dog workability. Enrolling in this program does not automatically elevate your dog to service dog or service dog in training status. Your dog must be free of any behavior issues that would prevent your dog from being your service dog (fear, aggression, etc). Your dog must be rock solid around people, dogs, and distractions. Service dogs are not behavioral project dogs. If your dog does have behavior issues, we will spend our time addressing those, not on service dog work. Photo/Video Release You hereby assign and grant Heart & Soul Dog Training the right and permission to use, reproduce, distribute, and publish the photograph(s), film(s), videotape(s), audio and video recording(s), electronic representation(s) and/or sound recording(s) made of me and/or your dog(s) at any time during the training and/or boarding of your dog(s) by Heart & Soul Dog Training, and you hereby release Heart & Soul Dog Training from any and all liability resulting from such use, reproduction, distribution, and publication. You hereby authorize the reproduction, sale, distribution, copyright, exhibit, broadcast, and/or electronic storage of any and all such photograph(s), film(s), videotape(s), audio and video recording(s), electronic representation(s) and/or sound recording(s) without limitation at the discretion of Heart & Soul Dog Training and You specifically waive any right to any compensation you may have for any of the foregoing. Grooming Your dog must have a short “kennel cut” while with us. Your dog is here for training, and when we do spend some time grooming, that is less time spent training, either your dog will need more time with us, or will learn less. If we need to groom your dog, there will be a minimum of $100 fee added each time. You authorize Heart & Soul Dog Training to conduct this training and to take your dog to specific places as required. A $500 non-refundable holding fee is due to reserve your spot and the remainder is due when you drop your dog off. If you do not pick up your dog on their go home date, their board & train will continue at $100/day. If your dog destroys our equipment (including collars, leashes, crates, you are responsible for reimbursing us for them). There are no refunds. * Thank you!We will be in touch with you shortly. If you would like to reach out to us, Victoria’s cell phone is 352-278-7404. After you submit your information, a $500 non-refundable holding fee is required to reserve your spot.
