DOG TRAINING REGISTRATION & QUESTIONNAIRE Please fill in or check off appropriate information. All classes are open enrollmentCLASSES Puppy Basic Intermediate Winnetka Com. Hse. PRIVATE Puppy Head Start Private Lesson Adopt/Purchase Eval. Pets for Vets PRIVATE, cont. Personal Shopper Day Training Evaluation Only Date of First Lesson or Class: MM slash DD slash YYYY Day of the Week: Location: How did you hear about Big Sky Dog Training? Please complete the following:Owner’s and/or Handler’s Name:(PLEASE NOTE: Owner and/or Handler must be at least 18-years-old.) Street Address: City: Zip Code: Primary Phone: Other Phone: Email: Dog’s Name: Known or Estimated Age: Breed(s) or Best Guess: How long has your dog been a member of your family? Did your purchase your dog from a breeder or adopt from a shelter or rescue? REFUND POLICY/CANCELLATION POLICY: PRIVATE LESSONS: IF A NO SHOW OR CANCELLATION IS MADE IN LESS THAN 12 HOURS FROM THE DATE OF SERVICE A $25.00 WILL BE ASSESSED. PACKAGES OF LESSONS MUST BE USED WITHIN 6 MONTHS. LIABILITY WAIVER FOR DOG SERVICES: I UNDERSTAND THAT MY PARTICIPATION IN ANY OF BIG SKY DOG TRAINING SERVICES (HEREBY ALSO REFERRED TO AS TRAINING) INCLUDES AN ELEMENT OF RISK FOR ME, ATTENDING FAMILY MEMBERS, GUESTS AND MY DOG, WHICH INCLUDES, WITHOUT LIMITATION, RISKS OF ILLNESS, FALLS, BITES AND INJURY THROUGH CONTACT WITH OTHER PARTICIPANTS, THEIR DOGS, OR INTERIOR/EXTERIOR SURROUNDINGS OF ANY FACILITY WHERE DOG TRAINING TAKES PLACE. I UNDERSTAND THAT PARTICIPATION BY ME, ATTENDING FAMILY MEMBERS/GUESTS, AND MY DOG IS VOLUNTARY AND THAT EACH PERSON HEREBY EXPRESSLY AGREES TO HOLD BIG SKY DOG TRAINING, ITS EMPLOYEES, OWNERS AND AGENTS, HARMLESS FROM ANY LIABILITY WHATSOEVER RESULTING FROM ANY INJURIES OR DAMAGES SUSTAINED AS A RESULT OF PARTICIPATION IN THE TRAINING. I, AND ATTENDING FAMILY MEMBERS/GUESTS, INDIVIDUALLY, AND ON BEHALF OF THEIR RESPECTIVE HEIRS, ASSIGNS OR SUCCESSORS, HEREBY EXPRESSLY WAIVES, RELEASES AND DISCHARGES BIG SKY DOG TRAINING, ITS EMPLOYEES, OWNERS AND AGENTS FROM ANY CLAIMS, DEMANDS, INJURIES, DAMAGES OR CAUSES OF ACTION THAT ARE IN ANY WAY RELATED TO PARTICIPATING IN THE TRAINING. BIG SKY DOG TRAINING MAKES NO REPRESENTATIONS, GUARANTEES OR PROMISES, IMPLIED OR EXPRESSED, THAT ANY TRAINING RECEIVED FROM BIG SKY DOG TRAINING WILL CURE A DOG OF ANY DANGEROUS PROPENSITIES. IT IS FULLY UNDERSTOOD THAT REGARDLESS OF THE DOG TRAINING RECEIVED BY THE ANIMAL, A DOG ALWAYS POSSESSES THE PROPENSITY TO BITE. I HEREBY AGREE TO INDEMNIFY AND HOLD HARMLESS BIG SKY DOG TRAINING, ITS EMPLOYEES, OWNERS, AND AGENTS FROM ANY AND ALL CLAIMS, OR CLAIMS BY ANY MEMBER OF MY FAMILY OR ANY OTHER PERSON WHILE ON THE GROUND OF ANY FACILITY WHERE DOG TRAINING TAKES PLACE, THE SURROUNDING AREA THERETO, OR ON MY OWN PROPERTY OR PUBLIC AREA AS A RESULT OF ANY ACTION BY ANY DOG, INCLUDING MY OWN. I AFFIRM AND HAVE PROOF THAT MY DOG IS CURRENT ON ALL VACCINATIONS APPROPRIATE FOR MY DOG’S AGE AND AS REQUIRED TO ATTEND TRAINING. I AGREE TO ABIDE BY ALL RULES PRESENTED DURING THE TRAINING. I ALSO UNDERSTAND THAT BIG SKY DOG TRAINING MAY USE FOR PUBLICITY, PICTURES OF MY DOG OR ME FOR PROMOTIONAL PURPOSES WITHOUT LIABILITY OR OBLIGATION TO ME. I ALSO AGREE TO REIMBURSE MONTANA C. HAYES FOR ANY EXPENSES SHE MIGHT INCUR AS A RESULT OF INJURIES OR ILLNESSES SHE MIGHT SUSTAIN AS A RESULT OF WORKING WITH MY DOG. I HAVE READ, UNDERSTAND, AND AGREE TO ALL TERMS AND CONDITIONS SET FORTH ABOVE and choose to take this lesson/class.SIGNATURE OF DOG OWNER TODAY'S DATE MM slash DD slash YYYY Consent PLEASE CHECK HERE TO CONFIRM THAT YOU ARE THE PERSON WHOSE NAME IS ENTERED ABOVE AND YOU ARE ALSO THE OWNER OR RESPONSIBLE AGENT FOR YOUR PET.REGISTRATIONDATE RECEIVEDDATE VERIFIEDNOTES Add RemovePROOF OF VACCINATIONSDATE RECEIVEDDATE VERIFIEDNOTES Add RemoveCLASS LESSON FEE / MANUALDATE RECEIVEDDATE VERIFIEDNOTES Add RemovePlease check any of the descriptions below which are applicable to your dog. You may choose as many as needed.Adult or Puppy Training House training Biting and/or nipping hands Biting and/or pulling on pants or other clothing Attention & focus Licking Chewing Digging Drop it Leave it Traveling in car Jumping out of car Excessive barking, howling, and/or whining Boundaries and/or bolting Car sickness Wild and uncontrollable behavior Resource guarding (food, toys, favorite people, etc.) Chasing family cats or other undesirable prey drive behaviors Crate or carrier training Overprotective at home and/or in public Obedience Recall (come/here), on-leash Recall (come/here), off-leash Sit and/or sit-stay Stay Down and/or down-stay Wait Walking on leash Pulling on leash Running away and/or trying to escape Jumping over or digging under fences Jumping on furniture Jumping on people Kitchen counter-surfing and/or stealing food Chasing cars, bicycles, etc. Advanced obedience skills Heel Quiet Socialization, Behavior and Comfort Dog shy People shy General aggression Territorial aggression Fear aggression or reactivity Displaced or redirected aggression Excessive excitement Stress or anxiety-related hyperactivity Growling Becoming "frozen" when anxious or afraid Dog socialization People socialization Strange places and/or new experiences Separation anxiety General anxiety Excessive barking, howling, and/or whining Pack orientation Phobic behavior or irrational fears Introducing to and/or preparing dog for baby Introducing to and/or preparing dog for new family pet Fear of, hyperactivity and/or pain aggression during veterinary visits Fear of, hyperactivity and/or aggression during groomed Fear of crate, carrier, and/or travel Fear reactivity History of being neglected, abandoned, and/or abused History of other major trauma Behavior towards and/or interactions with other family pets Understanding what your dog's body language means History with a punishment-based dog trainer Overprotective at home and/or in public Unpredictable behavior History of having bitten a person History of being attacked by other dogs History of attacking other dogs Barrier aggression Providing enough mental stimulation Establishing and/or building trust Inappropriate urination or indoor marking (dog is already house broken) Leash aggression and lunging Recent changes in behavior Grooming Bathing and conditioning coat Oral care (brushing teeth, gingivitis, etc.) Cutting nails and paw health Cleaning eyes and ears Itchiness, irritation, hot spots, and/or allergies Dry or oily skin and/or coat Anal gland health Excessive shedding and/or proper brushing Lumps, bumps, and/or other abnormalities Dog odor or "doggy smell" Fleas, ticks and other parasites Spaying or neutering Heartworm prevention and testing Pet care during weather extremes Incontinence Dog estrous (or "heat") cycle Food and Treats Excessive and/or smelly flatulence Upset stomach Food allergies Eating stools Resource guarding food/toys/treats Are there any additional concerns, behavior problems, or other details we should know about your pet?