Back to Basics with The Crazy Dog Lady

7231 Britt Bypass

Britt, MN  55710

218-741-1112 or judy.grumdahl@gmail.com

 

Name: _______________________________________

Address: _____________________________________

City: ________________________________________

State and Zip Code: ___________________________

Phone: ______________________________________

Email: ______________________________________

Dog’s Info

Name, Breed, Age): ____________________________

*Class or Seminar Desired: ______________________

 

 

Back to Basics with The Crazy Dog Lady......reserves the legal right to refuse to work with any dog based on behavior of dog and owner, either prior to registering for class, after registration, or during class.

 

 

***ALERT***

***Vaccine Requirement***

 

For the health of all dogs, I require PROOF of vaccination of the following:

Rabies (unless puppy is under 3 months of age), DHP-PV, (Bordetella is highly recommended)

 

 

Please bring treats, water for you and your dog to drink—a dish for your dog, toys if your dog likes toys…

..But most of all bring a positive attitude and a happy dog! It will be to your benefit if you give your dog a good run or exercise session so that they are not coming in on full throttle!

PLEASE READ AND SIGN.

I, the undersigned, in consideration of the enrollment for obedience training by Back to Basics with The Crazy Dog Lady, do hereby agree that I release and waive any right that I may have in law to recover medical payments, property damage, or bodily injury damages for any liability regardless of cost as a result of any injury I may sustain from any other dog or my own dog, dogs, or any property belonging to me, within the class situation of Back to Basics with The Crazy Dog Lady.

I further agree that I hereby release and waive any right that I may have at law to hold Judy Grumdahl (DBA as Back to Basics with The Crazy Dog Lady), employees, or volunteers liable for any injury.

I further agree that I am assuming the risk of participating in obedience training where there are other dogs whose temperament is unknown to me: that I assume full responsibility for any injury that may occur to me, to my dog or dogs, or other property, or any damages that would ordinarily be due me, that I waive any right that I may have to institute any suit or other proceedings to recover therefore.

I have read this paper and am fully aware that this contract constitutes a waiver and release of any liability of injury to me, my dog, dogs, or other property. I hereby certify that I am over 21 years of age, sober, and of sound state of mind.

Owner's Signature ________________________________________________________

Printed Name ____________________________________________________________

Date__________________________________________________ 

 

 

 

 

 

***OFFICE USE ONLY***

 

Certificate of vaccination on record   Y  ~ or ~  N

 

Date of Rabies: ____________ Expires: _______________

 

Payment received

(Amount Rec’d):

_________

 

Date of registration:

__________