Application

Perfecting communication between dogs and their people!

Small Group Class Questionnaire

* denotes required fields

*Owner Name:		*Telephone Home:
*Address:		Telephone Work:
*City:		Telephone Other:
State: Zip:		*Email:


Please choose your class:	Drop In Basic Class ($15/session) 7 Week Outdoor Adventure Class ($100)
*Person Handling Dog in Class:
If Minor, Age of Minor:	Years
(A handler 15 years of age and younger is required to have an adult attend class to assist minor. Thank you.)

*Dog's Name:
*Dog’s Gender: M F	*Dog's Age:

*Where did you acquire your dog? (Breeder, pet shop, Breed Rescue, shelter, etc.):
*Is your dog spayed or neutered?	Yes No
*Where is your dog when you are not home?
*How much regular exercise does your dog get?
*Do you have other dogs at home?	Yes No
If yes, do you have any issues between them?
*Does your dog play off-leash with other dogs?	Yes No
If yes, please specify:

*Is your dog sensitive about any part of its body? (i.e. tail touched, paws touched, etc.):	Yes No
*Is your dog possessive of food or toys?	Yes No
*Has your dog ever bitten another dog?	Yes No
*Has your dog ever bitten a human?	Yes No
If yes to any of the above, please describe:

*Specify brand of dog food fed:
*How many times per day fed:
*Have you ever trained a dog before?
If yes, at what facility?
*Collars used by you (please check all that apply):
Martingale/Greyhound/Premier-style Collar
Buckle Collar, Nylon or Leather
Body Harness
Prong/Pinch Collar
Head Harness (Gentle Leader, Halti, Snoot Loop, etc.)
Chain Training Collar
Other (Please specify):

*Do you or your dog have any pre-existing condition that may have an impact on training? (E.g. hearing loss): Yes No
If yes, please describe:
*Are there any specific issues you wish to address in the class?

*What else do you wish to accomplish in this class?

Is there anything else you may consider relevant?

*How did you hear of this training opportunity?

*Name of Veterinarian:
*Clinic’s Address:
City: State: *Zip:
*When was your dog's last vet visit?
*Reason?

Please read, then click Submit below.

Trainer reserves the right to refuse entry to any dog that is obviously sick or overtly aggressive. Trainer cannot guarantee each individual dog’s ability to learn and/or understand signals, commands, or cues.

Liability Release:

Owner agrees that Pawsitive Reactions, LLC/ Debby McMullen and Larry's Laundromutt and any referring organization and/or other participants will not be liable for any damage or loss resulting from failure of the dog to respond to any signals, commands, or cues taught to the dog by Pawsitive Reactions, LLC or Debby McMullen or resulting from counseling, instruction, or advice supplied to owner of dog.

Dog’s behavior now and in the future is solely the responsibility of the owner of the dog. Should any behavior on the dog’s part now or in the future result in damage to property, owner, or persons of some third party, owner agrees to assume full responsibility and liability to such third party for any and all such damage, and to absolve Pawsitive Reactions, LLC /Debby McMullen and Larry's Laundromutt and any referring organization and or other participants from any and all obligations to pay such damage to some third party.

All dogs are trained or otherwise handled or cared for by Pawsitive Reactions, LLC/Debby McMullen and Larry's Laundromutt and any referring organization and other participants without any liability whatsoever on Pawsitive Reactions, LLC/Debby McMullen and Larry's Laundromutt and any referring organization and or other participants for loss or damage from disease, death, running away, theft, fire, injury to persons, other dogs, other animals, or property by said dog, or other unavoidable causes. Adults are responsible for their minors.

Refund policy: No refunds given unless classes and or lessons are permanently cancelled by Pawsitive Reactions, LLC or death in immediate family of student. No refund if owner and/or handler misses or drops out of classes and or lessons. No pro-rates given for missed classes and or lessons.