Client Information and Service Agreement Name First Last Address(Required) Street Address Address Line 2 City Email(Required) Home/Cell Phone(Required)Dog's Name(Required) Breed(Required) Dog's Age(Required) Dog's Sex(Required) Male Female Medical History:Vet Office/Vat's name(Required) Current health problems/Medications:(Required) Yes No Please DescribePast medical conditions/Treatment:(Required) Yes No Please DescribeDoes your dog have any allergies, including food allergies?(Required) Yes No Please DescribeIs your dog easily handled by the vet staff?(Required) Yes No UntitledHas he/she ever had to be muzzled?(Required) Yes No May we contact and discuss health and behavioral issues with your veterinarian?(Required) Yes No History:Where did you obtain your dog?(Required) Breeder Individual Shelter Rescue Group Pet Store Friend/Relative Found stray Other How long have you had your dog?(Required) Do you have other pets?(Required) Yes No What kind, breed, age, sex, neutered?Has your dog ever bitten another animal, dog, or person? If yes, please describe.Has your dog ever shown any signs of aggression towards another animal, dog, or person? If yes, please describe.DietWhat type of food do you feed? (e.g., raw, dry kibble, canned)(Required) How often?(Required) How much?(Required) Does your dog finish all food at meals?(Required) Yes No ExerciseWhat type of exercise and how long does the exercise last?(Required)TrainingPrevious Training Check all that your dog knows: Sit Down Stay Come Walk nicely on leash Leave it Give Wait Go to your place Quiet Off (furniture or when jumps up) Others (including tricks):Please describe your main behavior concerns and goals: The Pend Oreille Pet Lodge will endeavor to create as safe an environment as possible for thetraining of my dog and will offer only sound, safe, and responsible training and instructions. PendOreille Pet Lodge will not be responsible for any unintentional or negligent errors, omissions, orincorrect assertions. I have been told by Pend Oreille Pet Lodge and understand the inherent risksof owning a dog, including but not limited to the risk of dog bites to myself or others, andconsequently I am and will remain responsible for the actions of my dog at all times, and I herebyagree to indemnify and hold harmless Pend Oreille Pet Lodge and trainer of any and all claims ofinjury, expense, costs, or damages caused by my dog. I understand that the recommendation of anyother product or service is not a guarantee of my satisfaction with that product or service. I authorize Pend Oreille Pet Lodge to take my dog into public spaces during his/her stay for thepurpose of training my dog. If you have left your pet with the kennel or trainer and the trainer determines that your pet is illor injured and requires medical attention, the trainer will first call the phone numbers listed aboveregarding your pet’s symptoms, treatment option and estimates of cost. If no one can be reachedhowever, please indicate below so the trainer and Pend Oreille Veterinary Service and Pet Lodgecan make important decisions for your pet in your absence. (Required) I authorize Pend Oreille Pet Lodge to administer or seek medical care for my dog(s) as determined appropriate by Pend Oreille Pet Lodge and I agree to indemnify and hold harmless Pend Oreille Pet Lodge for all and any results thereof. I will reimburse Pend Oreille Pet Lodge for any charges related to emergency care, including office visits, procedures, medications, surgeries, etc. I DO NOT authorize Pend Oreille Pet Lodge to administer or seek medical care for my dog(s) as determined appropriate by Pend Oreille Pet Lodge and I agree to indemnify and hold harmless Pend Oreille Pet Lodge) for all and any results thereof. Payment/ Cancellation Policy: I understand that under no circumstance are deposits ormonies paid toward training at The Pend Oreille Pet Lodge refundable or transferable. I alsounderstand that I am responsible for payment in full regardless of whether I choose to complete thetraining program. The Pend Oreille Pet Lodge Canine Training Team reserves the right to terminatetraining services at any time due to non-compliance and/or lack of cooperation from the client. Iwill arrive to training sessions on time and understand that tardiness shall result in missed trainingtime.Private Lessons: We require a minimum of 48 hours advance notice for cancellation orreschedule of private lessons. Failure to give appropriate advance notice and “No- Shows” willresult in session forfeiture. The first visit is considered session #1 of program and all packagesessions must be completed within a five-month period from purchase date. There are no refunds offered for unused sessionsin private lesson programs and monies are not transferable.Group Classes: Due to limited number of registration slots available: we offer a 100% refund forcancellations at least 7 days prior to the start date of the first class. We do not offer any refunds forcancellations less than 7 days before the start date of the first class. There are no make-up lessonsfor class sessions that you miss. You can schedule a (50% discounted rate) private lesson for amissed session within 30 days of the missed class session. Vaccine Policy: I agree that the above- stated dog is current on (age appropriate) vaccinationsthat have been administered by a veterinarian. Including Bordetella (every 6 months), DHPP,and Rabies. I understand that I must provide appropriate documentation prior to the first visit. Photo/ Video Release: I authorize Pend Oreille Pet Lodge to use my pet’s photograph(s) and/or video(s) taken during training sessions for educational and promotional purposes in any type ofmedia. I have read and accept these policies(Required) I have read and accept these policies Date(Required) MM slash DD slash YYYY
