SCHEDULE EVALUATION

<span style="color: #008000;"><strong> GET TRAINING STARTED BY SCHEDULING AN EVALUATION.</strong></span>

The information which you provide on this form is for the sole use of Performance Dog Training and will remain confidential.

Step 1 of 4

Name*
First Last
Address*
Street Address City State ZIP Code
Phone*
Email*

Dog's Name*
Breed*
Birth Date*
MM
DD
YYYY
Gender*
- Male
- Female
Veterinarian*
Dog's Training Needs*

Preferred Date of the Evaluation.*
Date Format: MM slash DD slash YYYY
Preferred Time of the Evaluation.*

: HH

MM
Is there another time that you prefer?*
Weekends or Weekdays? Morning or Afternoon?

GENERAL AGREEMENT AND LIABILITY WAIVER
In consideration of the acceptance of this enrollment and the opportunity to participate in dog classes, private training, seminars, workshops, outings, events with Dan Roy dba Performance Dog Training LLC, I (we) agree to hold Dan Roy dba Performance Dog Training LLC harmless for any claim for loss or injury which may be alleged to have been caused directly or indirectly to any person or thing by the act of my (our) dog(s) while in, upon or near the premises and I (we) personally assume all liability for any such claim. I (we) further agree to hold the aforementioned parties harmless from any claim for loss of my (our) dog(s) by disappearance, theft, death, or otherwise, and from any claim for damage or injury to the dog, whether such loss, disappearance, appearance, theft, damage or injury, be caused or alleged to be caused by the negligence of the parties aforementioned, or by the negligence of any other person or any other cause or causes. I (we) hereby assume the sole responsibility for and agree to indemnify and save the aforementioned parties harmless from any and all loss and expenses (including legal fees) by reason of the liability imposed by law upon any of the aforementioned parties for damage because of bodily injuries, including death at any time resulting there from, sustained by any person or persons, including myself (ourselves) or on account of damage to property, arising out of or in consequences of my (our) participation in these classes, private training, seminars, workshops, outings, events, howsoever such injuries, death or damage may be caused or may have alleged to have been caused by negligence of the aforementioned parties or any of their employees, agents, or any other person.
Unless payment has been made in advance, payment for services rendered by Performance Dog Training LLC will be due in full, immediately following that service.
I HAVE CAREFULLY READ THIS LIABILITY, AND FULLY UNDERSTAND THE CONTENTS THEREOF. I/WE ARE AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN: MYSELF, DAN ROY DBA PERFORMANCE DOG TRAINING LLC. I SIGN IT OF MY OWN FREE WILL FOR MYSELF OR MY CHILD OR ANY INDIVIDUAL TO WHOM I AM THE GUARDIAN.
Guardian must sign for anyone under 18 years old.
SIGNATURE*
- I Agree
Name
This field is for validation purposes and should be left unchanged.