ENROLLMENT FORM CLASSES & WORKSHOPS Client Name First Name Last Name Email Phone (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Dog General Information Name Breed Age Dog's current weight Spayed/Neutered? Yes No Scheduled Name of Your Vet Is your dog up to date on all immunizations and vaccinations? (puppies for play & learn must have first set of core vaccinations and be parasite-free to enroll) Where did you get your dog from and how old were they? Does your dog have any medical conditions or dietary restrictions I should be aware of? If yes, please describe. Training Questions Let's talk goals! Have you ever done formal training with your dog either in a class or with a private trainer? Yes! No, this is my first time! How does your dog respond to another dog when they see it? Please describe Example : my dog just wants to play and will bark/pull until they do, my dog is happy to see other dogs but remains calm, my dog is nervous around other dogs, etc What are 3 goals you want to accomplish with your dog? These can be anything from short term goals within the class duration or long term goals! Do you have any concerns or physical limitations that may affect the ability to work with your dog? Please describe Anything else I should know about you or your dog? How did you hear about Grace Pomeroy Training? Grace Pomeroy Training Client Agreement * RELEASE OF LIABILITY I, the undersigned hereby, acknowledge that I am voluntarily participating in Dog Training with Grace Pomeroy Training. Grace Pomeroy Training will exercise all necessary and proper care and precautions to keep all participants and dogs safe during training sessions in order to prevent injury to any person, property, other dog or person. However, because dogs are animals and may be unpredictable, Grace Pomeroy Training cannot protect against every potential injury, risk or accident. Participant agrees to hold Grace Pomeroy Training from any and all claims not covered by insurance of injury, loss, cost, expenses, or damage caused by the actions of Participant's dog during the course of training/boarding, or under the care, custody or control of Grace Pomeroy Training. I hereby accept and assume all risks associated with my participation in the training programs and classes, including, but not limited to: the risks of any and all injuries to myself, my dog and any of my family members or third parties who may attend; the risks that my dog may cause injury to other persons and/or dogs involved. CANCELLATION / RESCHEDULING POLICY Please Note, there is are no refunds or make up sessions for missed group classes I have read and agree to terms and conditions Thank you!