Dog Training Registration Form

* Indicates required field

Your Name *

First

Last

Full Address *

Phone Number *

Email Address *

Pet's Name *

D.O.B or age *

Breed *

Sex *

Vet's Name *

First

Last

Health issues / medications / allergies? *

Where did you acquire your dog? *

What type of food do you feed? How often? How much? *

List all members in the household, their names and ages. *

Are there any other pets in the home? *

If yes, please specify and describe relationship *

Briefly describe a day in the life of your dog, including how much and what kind of exercise they get *

What are you seeking help for? *

What are your goals for your dog? *

Has your dog ever bitten anyone or another animal? *

If yes, what were the circumstances? *

What is your dog's reaction when a stranger enters the home? *

How did you hear about me? Please be specific so I can thank them. *

I, the undersigned, understand that my participation in a dog training session may pose some risk to myself, members of my family, my guests, and my dog(s) and other pets and expressly assume the risk of any damage or injury incurred as a result of a dog training session conducted by or on behalf of Marlo Hiltz. Marlo Hiltz reserves the right to deny or refuse a dog because of safety issue with other dogs. To minimize all risks, I agree to disclose to Marlo Hiltz any danger my dog(s) may present and concerns I may have. In consideration of my participation in a dog training session or sessions conducted by or on behalf of Marlo Hiltz, I, on behalf of myself and any minors attending the dog training session(s) with me, agree to waive, release, and agree to hold harmless Marlo Hiltz and any and all associated employees, volunteers, agents, and insurers, from any and all causes of actions, claims, losses, injuries, expenses and damages of any kind arising on my behalf or my dog(s) in connection with the dog training session. I am responsible for damages caused by my dog(s) and/or family members. All puppies coming to class must be on a leash or in a travel crate. I understand that the recommendation of any other product or service is not a guarantee of my satisfaction with that product or service. I give permission for my dogs image to be used on social media. Please enter your full legal name. This serves as your signature. *

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