K9 Training School Application Form Name* First Last Cell Phone*Alternate PhoneEmail* Address Street Address City ZIP Code Dog Name*Breed*Age*Age in Months or Years*YearsMonthsWeeksGender*MaleFemaleWeightin PoundsVet Organization Name:*Doctor NameVet Phone NumberI authorize Topline K9 Solutions to take my pet to the above named veterinarian for veterinary care if, in their opinion, care is needed and I will be responsible for payment for treatment. If it is an immediate emergency and my regular clinic is not open or it is a matter of life or death of the pet, I give Topline K9 Solutions the authority to take my pet to the nearest emergency clinic and I assume all financial responsibility for any bills incurred up to the amount authorized below. I also understand that Topline K9 Solutions will be released from all liability related to the treatment, expense or loss of my petYesNoI authorize Topline K9 Solutions to approve treatment up to: (provide $ amount): $Is Your Dog Spayed/Neutered?:*YesNoDate of Last Rabies Shot Date of Last DHLPP Vaccine Date of Last Flea Prevention Medicine (*If fleas are found while dog is with us, we will treat the dog at the owner's expense unless directed otherwise): Date of Last Heartworm Prevention Medicine Is your dog on any medications currently? If yes, provide name and dispensing instructions:I authorize Topline K9 Solutions to dispense medications as directed aboveYesNoYour Training Goals and Additional notes for TrainerWhat is your Date/Timeframe you would like to start training and availability for us to pick up your dog and do your consults? Daytime, evenings, weekends?How Often Does Your Dog Eat and How Much? (Cups), Also any Additional Notes on Food Routine (eats in crate, sits for food, any food allergies? etc.)What type of Chewies/Treats Do You Give Your Dog?Is your dog crate trained?YesNoWhere Is the Dog Kept When Alone/Unsupervised?Do you have a fenced in yard?YesNoYour Home and Work Routine (briefly)Is your Dog Housetrained? If so, how reliable? Explain:Is your dog aggressive to kids and/or adults? If so, please explain*Is your dog aggressive to dogs and/or cats? If so, please explain*Does your dog live with kids?YesNoHow often do you have guests over to your home?What is Your dog's energy level? and What kind of activities do you currently do with your dog on a regular basis and how often per day or week? (leisurely walks, fetch, couch cuddling, long walks, runs, dog park, hikes, dog sports, etc.):How did you hear about Training School?Where did you get your dog?How long have you had your dog?May we have your permission to use class/consult photos and/or videos in our marketing program?YesNoUpload PhotoAccepted file types: jpg, gif, png.I understand that training is not without risk to my dog. I hereby waive and release Topline K9 Solutions LLC, its officers, employees, owners, members, contractors, and agents from any injury or damage resulting from the action of the dog, and I expressly assume the risk of any such damage or injury while attending any training session, or while on the training grounds or the surrounding area thereto. In consideration of and as inducement to the acceptance of my application for training I hereby agree to indemnify and hold harmless Topline K9 Solutions LLC, its officers, employees, members, contractors, agents from any and all claims, or claims by any member of my family or any other person accompanying me to any training session or while on the grounds or surrounding area thereto as a result of any action of any dog, including my own. If agree, please sign below.* This iframe contains the logic required to handle Ajax powered Gravity Forms.