Training Form Contact Us Fill out the “Intake Form” below. We will be in touch soon! Please complete all sections. Write “no” or “not applicable”, if there is no information. Have a Question? Call Us: 613 319 0527 or use our Contact Form. Test - Private Training Intake & Goal Assessment The canine clubhouse_ Website form_16.6.2020 (#11) Client & Dog InformationDogs RoutineTraining History/ReinforcersClients GoalsDog Training Waiver Client & Dog InformationSome description about this sectionGuardians NameDateHome PhoneWork PhoneCell PhoneEmailAddressAddress Line 1Address Line 2CityProvincePostal CodeCountrySelect CountryCanadaUnited States (US)Do you prefer training in your home or at the school? Home SchoolDog's NameBreed/Age/SexWhere did you get your dog?Has your dog had any major health concerns including allergies? Family members and age who live with you Family Member Age (years) Other pets (name, species, age, gender and spay/neuter) Most recent vet visit and results Date visited Results How did you hear about us?- Select -InternetFriend or familyReferralInternet SerachWalk InFlyerFacebook / Social MediaEmailPreviousNextDogs RoutineSome description about this sectionDescribe your dog’s daily routineWhat does your dog do for exercise, and how often/for how long?What does your dog do when you’re gone from the house? Any destructive behavior?What kind of toys, chews, etc. does your dog play with, and how often? When does he/she play with his/her toys?PreviousNextTraining History/ReinforcersSome description about this sectionHas your dog ever bitten someone? If so, did your dog draw blood? Please describe what happenedWhat do you need help with? Please describe the problem behaviorsHave you done any training with your dog, or had he/she done any before you adopted him? Where did you do the training? Can you describe the basic approach you learned to train your dog? Did you feel you got the results you were looking for?What are your dog’s favorite foods or treats?What are your dog’s favorite toys?What are your dog’s favorite activities?PreviousNextClients GoalsSome description about this sectionWhat would you like your dog to do?What would you like to be able to do with your dog?PreviousNextDog Training WaiverBy submitting the private training questionnaire, you are agreeing to the following Private Session Policies. These guidelines are designed with client and dog safety in mind, and when followed create a cooperative and cohesive training experience through which students and dogs can most effectively learn. Private Session Polices These guidelines are designed with client and dog safety in mind, and when followed create a cooperative and cohesive training experience through which students and dogs can most effectively learn. Dogs not enrolled in training are not permitted in the training hall or waiting area. Please leave all other pets at home. A person may only handle one dog during training. If two dogs from the same household are enrolled another handler must be present. Dogs must remain on leash at all times unless clients are otherwise instructed. Ill or contagious dogs are not permitted in the training hall. Bitches in season must be diapered and the instructor notified in advance. All behavioral concerns must be disclosed in writing in the behavior questionnaire prior to commencement of training. Corrective training techniques or equipment such as choke, slip, prong or shock collars are not permitted. Registration and Payment Private sessions are filled on a first-come-first-served basis. Spots are not held until payment is received. Payment must be received within two days of receiving the invoice or notice to pay, lest the tentative appointment be canceled. If a session is booked less than five days in advance, payment is due immediately in order to hold the booking. All services are non-transferrable/non-refundable Cancellation Policy To maintain a high level of service we are unable to offer refunds or credit within 48 hours of your Private Session or Transfer Session. Cancellations of Private training in advance of 48hrs will receive credit, but no refunds will be offered. In the case of any cancellation on the part of The Canine Clubhouse the instructor will contact the clients scheduled for the affected session by phone and/or email and the session will be rescheduled. No-shows/late cancels will not be refunded or credited. Photo & Video Release In submitting the registration and/or payment, clients agree to release photo and video to the ownership of The Canine Clubhouse for promotional or educational purposes. Agreement to Hold Harmless & Assumption of Risk The client understands that dog training services and activities are not without risk to themselves, dogs, property or other people. It Is the client’s responsibility to use appropriate safety measures at all time, including muzzling and leashing said dog in the presence of other people and animals. The client expressly assumes the risk of any damage or injury incurred to any person, animal or property as a result of a dog training session conducted by or on behalf of The Canine Clubhouse. The client agrees to absolve and hold harmless The Canine Clubhouse, Amanda Elliot, Caroline Orfali and any other parties of any claims of injury, expense costs, or damages caused by the actions associated with any service provided. The client agrees to make known any and all training, behavioral and health problems or concerns at the time of registration and agree to assume all responsibility for the actions of their dog(s) at the time of service and in future. The Canine Clubhouse is not responsible for any injury to or destruction of any person, animal or property at the time of service or in future. The client understands that The Canine Clubhouse will make no guarantee of results of the training services provided (behaviors are not static) and agrees to pay all fees at the time requested. The client understands that behavior modification requires patience, commitment and consistency, as well as following the training guidelines and recommendations set by the trainer. The client agrees to follow the private trainers’ instructions during the visit to ensure his or her safety. I have read and agree to the Terms & Conditions and Policies.Do you have any additional comments, questions or concerns?Signature Sign Here Signature Date Previous Submit Form Have a Question? Call Us: 613 319 0527 You can also use our Contact Form.