Canine Good Citizen

Personal Information

Are you a new, or existing customer?*

Existing Customer
New Customer

Name*

First Last

Has your mailing address changed?*

Yes
No

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Canine Good Citizen*

Price: $125.00

You will be routed to PayPal to complete your payment once this form is submitted.

Pet Information

Dog's Name*

First

Age*

Sex*

Male
Female

Breed*

Weight*

Color/Markings*

Spay/Neutered*

Yes
No

Please list any health concerns to be aware of

Additional Information

Please list any additional information that we should be aware of:

I understand that I must provide up-to-date vaccine records prior to class or I will be not allowed to participate. This includes the Bordetella vaccine.*

Yes

Vaccine Records

If you have access to digital copies of your vaccine certificates, please upload here. Otherwise please fax Vaccine Certificates to (716) 931-5921, or bring them to your first appointment. (Rabies, Kennel Cough/Bordatella, and DHPP are required)

Drop files here or

Veterinary Clinic Name*

Liability Release and Training Agreement*

LIABILITY RELEASE AND TRAINING AGREEMENT

1. I agree that I have hired K9 Connection, as training professionals, to determine which tools are necessary to help me train my dog. I understand that I will obtain the best training results by following the instructions of the K9 Connection trainer(s). I further understand that I am solely responsible for the training of my dog.
2. I certify that my dog is in good health, is free from fleas, ticks, heartworms, and all other parasites, and has received all required vaccinations, including: canine distemper, parvo virus, hepatitis, parainfluenza, bordetella, and rabies. I agree that I am under a continuing obligation to report to K9 Connection any signs of illness or infection in my dog.

3. In the event that my dog requires emergency veterinary treatment while attending a Boot Camp program, I agree that K9 Connection, in its sole discretion, will transport my dog to an appropriate veterinary facility for treatment and will immediately attempt to contact me. I assume all financial responsibility for veterinary treatment.

4. K9 Connection strives to keep a clean and sanitary environment. I understand that even in cleanest environments, infections, diseases, and parasites may be transmitted between animals.

5. I understand and agree that if attending boot camp or day training, my dog may be placed in a kennel for periods of time during the day and/or night to allow for rest and downtime.

6. I understand that dogs are animals and even in the most controlled and well-supervised environments, they may engage in inappropriate animal behavior. This includes, but is not limited to, rough playing, nipping, aggression, and dog bites. I further understand that although K9 Connection staff closely monitors dog socialization and play to prevent injury, it is possible that my dog may receive minor nicks and scratches from other dogs. I agree that K9 Connection may use “corrections” to interrupt and/or stop my dog’s inappropriate behavior. Such corrections include, but are not limited to, the use of spray bottles of water and compressed air canisters.

7. I understand that my account must be paid in full prior to or at the first training session, and that there will be no refunds. K9 Connection reserves the right to change rates over time.

8. I understand that any remaining balance or unused training will expire one year after day of purchase.

9. I understand that in order to receive a refund for my deposit I must cancel two-weeks (fourteen days) prior to the start of my program. I understand that cancelations or rescheduling beyond the two-week period will result in my deposit to become non-refundable and non-transferable. Refunds will be credited back in the original form of payment. To cancel or reschedule an appointment please contact our office directly to speak with a representative.

10. I understand that if I must cancel or reschedule an appointment, I must provide 24 hours advance notice. Failure to do so will result in forfeiture of that lesson.

11. I understand that I am responsible for reading any literature provided by K9 Connection or by the manufacturers of any products used in my dog’s training.

12. I agree that training collars will not be left on my dog overnight or while my dog is unattended.

13. Missed group classes cannot be made up without express consent from management. Group class membership weeks begin on Monday and end on Sunday. Group class membership fees are determined based on the average number of classes per month, taking into consideration closings for holidays, seminars, etc… K9 Connection reserves the right to remove anyone from group classes, for any reason.

14. I understand that although K9 Connection has successfully trained many aggressive dogs, there are no guarantees that aggression will completely recede with training. I agree that if my dog has displayed or continues to display aggression toward other dogs and/or people, it is my responsibility to muzzle my dog and to avoid potential problem situations at all times, not solely during training sessions.

15. I agree that in the event my dog engages in an act of aggression toward another dog or person while participating in dog training, K9 Connection staff may, in their sole discretion, use reasonable physical force to interrupt and stop the aggression. I further agree that I am solely responsible, financially or otherwise, for any harm or damage to other dogs, persons, and/or property arising out of my dog’s behavior.

16. I agree to allow K9 Connection to photograph and/or videotape my dog for use in print, publication, and promotion of K9 Connection.

Acknowledgement of Risk:
I understand that attendance and participation in K9 Connection dog training, daycare or boarding is not without risk to myself, to my dog(s), and/or to third parties, and/or the dog(s) of third parties. The risks include, but are not limited to, the risk of property damage, personal injury from dog bites, scratches, or other injuries, death, infectious disease, and parasites. I agree that my dog’s attendance and participation in K9 Connection dog training, daycare or boarding is voluntary and was undertaken with my knowledge of the known risks and other risks that may result from my dog’s participation dog training.
Assumption of Risk:
I agree that I have been informed of the risks associated with dog training and have assumed the risk of my dog’s attendance and participation in K9 Connection dog training, daycare or boarding.
Release of Liability:
In consideration for my dog’s attendance and participation in K9 Connection dog training, daycare, or boarding, I fully release K9 Connection from any and all claims and/or liability arising out of my dog’s attendance at, or participation in, dog training, including all claims for personal injury, wrongful death, and property damage. I agree to defend, indemnify, and hold harmless K9 Connection from any and all claims and costs, including attorney’s fees, arising out of or relating to my dog’s attendance at, or participation in, K9 Connection dog training, daycare or boarding, including claims of negligence against K9 Connection, it’s employees, officers, agents and/or volunteers.

By typing your name below, you are acknowledging that you have carefully read this Liability Release and Training Agreement and understand its contents.*

First Last

Date*

Signature*