Cowichan Canine Registration Form & Training Services Agreement for Group Classes, Playgroups and Workshops

Cowichan Canine Registration Form & Training Services Agreement for Group Classes, Playgroups and Workshops
Before you begin to complete this registration form, please take the free on-demand Orientation Class (if you have not done so already). Please enter the date you attended Orientation Class in this box:* To take the Orientation Class, go back to the Orientation Class page on our Cowichan Canine website and click on the link. Attending Orientation Class is a requirement for participating in our classes. Dog's name* Owner's / handler's Last Name* Owner's / Handler's First Name* If you so wish, please indicate your preferred personal pronoun Street address* City* Postal code* Cell phone number Secondary cell phone number, or home landline Work phone number, if any Email address* Please indicate whether you consent to have your email address added to our email list.* Yes No We send out a Newsflash about once a month. You can unsubscribe at any time. Dog's breed or breed mix* Dog's date of birth (or age)* Age at purchase / adoption* Dog's gender* Male, intact Male, neutered Female, intact Female, spayed Hermaphrodite How did you find out about Cowichan Canine?* Dog's veterinarian* Dog’s medical issues, if any.* If none, please type "None". Does Dog have any allergies? Please respond Yes or No. If Yes, please indicate what your dog is allergic to.* It is important for us to know if your dog has any allergies, especially food allergies, as we use food for training. Does Dog take any medications?* If none, please type "None". What training have you done with Dog to date?* Does Dog bark or growl on walks?* No Dog may occasionally bark or growl at new or weird things Dog usually or always barks or growls at passing dogs Dog usually or always barks or growls at strangers and/or children Please tick all that apply. If Dog usually or always barks or growls on walks, please describe in detail: Has Dog ever bitten another dog or a person?* Yes No If yes, please contact us to discuss. What are your training goals for your Dog?* Please indicate which class you would like to sign up for at this time.* (Puppy Start Right, Pet Manners, Scent Detection, etc) If you are signing up for a linear class, like Pet Manners or Scent Detection, please indicate which start date you are signing up for Please read carefully the following information and indicate your consent to each item by clicking the respective radio button.* CLASS SIZE* Classes are strictly limited as to number of students, to maximize the time for personal attention and individual coaching. FIRST CLASS* For your first class, please arrive 15 mins early if you need to complete your registration process. ON LEASH & SCOOP THE POOP* Please keep your Dog on leash at all times and scoop the poop. FAMILY MEMBERS* Family members, including children over the age of 6 years, are most welcome to attend class with you. Children must, however, be able to sit quietly for the entire class. You are responsible for your child at all times. Unfortunately, we do not have anybody available to help mind your child for you. Children can be wonderful when it comes to socializing and training puppies, but please BE AWARE that your child may be at risk from some dogs that may not be as comfortable around children as your own Dog may be. Your child must NEVER UNDER ANY CIRCUMSTANCES approach any of the other dogs in class, or otherwise interact with people, dogs or equipment, without first receiving EXPRESS PERMISSION TO DO SO FROM THE INSTRUCTOR. YOU ARE LIABLE for your child’s actions AT ALL TIMES. MINIMUM STUDENT AGE* is 16 years of age, unless accompanied by a parent. For safety reasons, children under 18 years of age are not permitted in our Reactive Dog Programme. HEALTH & VACCINATION STATUS* You cannot come to class if your Dog should happen to pick up fleas or any other parasite or communicable disease. We will hold your attendance in abeyance until your Dog has recovered. The same applies to female dogs in season. For each of parvo and distemper, we require either a vaccination certificate no older than 3 years or an antibody titer test no older than 1 year. PUPPY START RIGHT* We encourage you to discuss your Dog’s attendance in class and playgroup with your veterinarian. Research has shown that it is very important for puppies to receive socialization from a young age, before they have been fully vaccinated – please refer to the AVSAB Position Statement On Puppy Socialization, available from our website, or from the American Veterinary Society of Animal Behavior website avsab.org. By signing this registration form, you warrant that Dog has been seen by a veterinarian and appears to be in good health and does not appear to show any signs of any communicable disease or parasites. Such conditions include, but are not limited to, soreness of any body part, runny eyes, runny nose, itchy/infected ears, diarrhea, fleas, lice, intestinal worms, etc. My Dog is over 18 weeks old and am NOT registering my Dog for Puppy Start Right. REMOVAL FROM CLASS* The Instructor may, at her sole discretion, remove you and your Dog from class if either of you is considered to be a threat of any nature to yourself or any person or animal present, or if you, despite repeatedly being asked not to, continue to use corrections, including, but not limited to, leash corrections, scolding, or shouting at your Dog. Such actions are counter-productive to the successful outcome of the training, and it may frighten not only your Dog, but also the other dogs in class, and it offends their owners and the Instructor. No refund will be given under such circumstances. SCHEDULE OF CLASSES & HOMEWORK* The class schedule is available through our website, where it will be updated from time to time – so please check in regularly! Please use the schedule to plan and book your class attendance. Students are expected to complete homework in between each class in order to progress to graduation level. TRAINING EQUIPMENT* Electric shock collars, choke chains, prong collars and any other corrective implements are not conducive to modern dog training and are EXPRESSLY PROHIBITED from our classes. If a muzzle has been prescribed for your reactive Dog, this must be worn at all times when at the training centre and surrounding areas. Your Dog will then need to be conditioned to love to wear the muzzle. LIABILITY WAIVER - 1* The Owner/Handler agrees to indemnify and hold Cowichan Canine Behaviour & Training Ltd and/or Lisbeth Plant and/or any of their employees/agents (“Instructor”) harmless from any and all liability for any loss, damage, injury or illness to persons, animals or property, including if Dog causes an accident or property damage, or bites or injures any other dog, animal or person (including but not limited to Instructor), during or after the term of this Agreement. LIABILITY WAIVER - 2* Owner/Handler agrees that Instructor shall not be liable for any loss or damage for any reason unless said loss or damage was a direct and undeniable result of Instructor’s negligence. If Dog causes property damage, or bites or injures any other dog, animal or person during or after the term of this Agreement, then the Owner/Handler agrees to defend and indemnify Instructor and Instructor’s agents from any resulting claims, demands, lawsuits, losses, costs or expenses, including attorney fees. If Dog is injured in a fight or in any other manner during or after the term of this Agreement, the Owner/Handler assumes the risk and agrees that Instructor shall not be held responsible for any resulting injuries, losses, damages, costs or expenses whatsoever. LIABILITY WAIVER - 3* Client understands that socialization between animals, whether on or off leash, is always dependent on the polite behaviour of all parties involved, and that accidents may happen at any time. Likewise, although Dog may have performed satisfactorily on the recall exercises in class, Client understands that there is always a risk that a dog may be distracted and run away, and also that participation in a Playgroup is no ‘safer’ than walking your dog on or off leash in any other circumstances. Client agrees to assume full responsibility for any actions of Dog or Client, and for the consequences of any actions by other dogs or animals or people affecting Dog or Client, and that Cowichan Canine and/or Cowichan Canine’s agent will be held free of any resulting claims, demands, lawsuits, losses, costs or expenses, including attorney fees, associated with any actions by Dog or Client, or affecting Dog or Client. LIABILITY WAIVER - 4* Please use your common sense and judgment when it comes to where and when you let your dog off leash, and when deciding with which dogs and people you should let your dog interact. If there are ever children, horses, cats or other animals or other individuals nearby, please put your dog on leash. Do not trust your dog's or any other animal's or person's safety to your ability as a dog trainer. PANDEMIC WAIVER* Each time the Owner/Handler attends Cowichan Canine’s premises, he/she declares him/herself and all other persons accompanies the Owner/Handler to class to be in compliance with Cowichan Canine’s from time to time published Health Declaration and Safety Plan regulations (available on https://cowichancanine.ca). SCOPE* This Agreement is binding upon the Owner/Handler, and the members of the Owner's/Handler's family and household. TERMINATION* Cowichan Canine 's duties hereunder shall terminate if (a) in an Instructor's sole judgment Dog is dangerous or vicious to Instructor or any other person or animal, or interferes with the training of other dogs, or (b) the Owner/Handler breaches any term or condition of this Agreement or (c) either party cancels the Agreement. Upon termination in accordance with the foregoing, Instructor's duties shall terminate but all other provisions of this Agreement shall continue in full force and effect. VIDEO & PHOTOGRAPHY WAIVER* The Owner/Handler grants Cowichan Canine the permission to obtain and use photographic and video graphic images of the Dog and Owner/Handler during their participation in its programmes and activities. No permission granted. REGISTRATION PROCESS* Complete and submit this form. Email your dog's vaccination certificate to info@cowichancanine.ca Submit your payment VACCINATION RECORD* I have emailed my dog's vaccination or titer certificate to info@cowichancanine.ca Vaccination certificate must be no older than three years. Titer certificate must be no older than one year. Please indicate date and method of payment:* If you do not yet know which class to sign up for, please enter "TBD". Please enter today's date in format YYYY-MM-DD* Format: YYYY-MM-DD SIGNATURE - By typing your full name in this box and then submitting the form to us, you are signing this registration form and warrant that you have truthfully answered all questions and read and understood all conditions in this form.*

Before you begin to complete this registration form, please take the free on-demand Orientation Class (if you have not done so already). Please enter the date you attended Orientation Class in this box:*

To take the Orientation Class, go back to the Orientation Class page on our Cowichan Canine website and click on the link. Attending Orientation Class is a requirement for participating in our classes.

Owner's / handler's Last Name*

Owner's / Handler's First Name*

If you so wish, please indicate your preferred personal pronoun

Secondary cell phone number, or home landline

Work phone number, if any

Please indicate whether you consent to have your email address added to our email list.*

Yes

We send out a Newsflash about once a month. You can unsubscribe at any time.

Dog's breed or breed mix*

Dog's date of birth (or age)*

Age at purchase / adoption*

Dog's gender*

Male, intact

Male, neutered

Female, intact

Female, spayed

Hermaphrodite

How did you find out about Cowichan Canine?*

Dog’s medical issues, if any.*

If none, please type "None".

Does Dog have any allergies? Please respond Yes or No. If Yes, please indicate what your dog is allergic to.*

It is important for us to know if your dog has any allergies, especially food allergies, as we use food for training.

Does Dog take any medications?*

If none, please type "None".

What training have you done with Dog to date?*

Does Dog bark or growl on walks?*

Dog may occasionally bark or growl at new or weird things

Dog usually or always barks or growls at passing dogs

Dog usually or always barks or growls at strangers and/or children

Please tick all that apply.

If Dog usually or always barks or growls on walks, please describe in detail:

Has Dog ever bitten another dog or a person?*

Yes

If yes, please contact us to discuss.

What are your training goals for your Dog?*

Please indicate which class you would like to sign up for at this time.*

(Puppy Start Right, Pet Manners, Scent Detection, etc)

If you are signing up for a linear class, like Pet Manners or Scent Detection, please indicate which start date you are signing up for

Please read carefully the following information and indicate your consent to each item by clicking the respective radio button.*

CLASS SIZE*

Classes are strictly limited as to number of students, to maximize the time for personal attention and individual coaching.

FIRST CLASS*

For your first class, please arrive 15 mins early if you need to complete your registration process.

ON LEASH & SCOOP THE POOP*

Please keep your Dog on leash at all times and scoop the poop.

FAMILY MEMBERS*

Family members, including children over the age of 6 years, are most welcome to attend class with you. Children must, however, be able to sit quietly for the entire class. You are responsible for your child at all times. Unfortunately, we do not have anybody available to help mind your child for you. Children can be wonderful when it comes to socializing and training puppies, but please BE AWARE that your child may be at risk from some dogs that may not be as comfortable around children as your own Dog may be. Your child must NEVER UNDER ANY CIRCUMSTANCES approach any of the other dogs in class, or otherwise interact with people, dogs or equipment, without first receiving EXPRESS PERMISSION TO DO SO FROM THE INSTRUCTOR. YOU ARE LIABLE for your child’s actions AT ALL TIMES.

MINIMUM STUDENT AGE*

is 16 years of age, unless accompanied by a parent. For safety reasons, children under 18 years of age are not permitted in our Reactive Dog Programme.

HEALTH & VACCINATION STATUS*

You cannot come to class if your Dog should happen to pick up fleas or any other parasite or communicable disease. We will hold your attendance in abeyance until your Dog has recovered. The same applies to female dogs in season. For each of parvo and distemper, we require either a vaccination certificate no older than 3 years or an antibody titer test no older than 1 year.

PUPPY START RIGHT*

We encourage you to discuss your Dog’s attendance in class and playgroup with your veterinarian. Research has shown that it is very important for puppies to receive socialization from a young age, before they have been fully vaccinated – please refer to the AVSAB Position Statement On Puppy Socialization, available from our website, or from the American Veterinary Society of Animal Behavior website avsab.org. By signing this registration form, you warrant that Dog has been seen by a veterinarian and appears to be in good health and does not appear to show any signs of any communicable disease or parasites. Such conditions include, but are not limited to, soreness of any body part, runny eyes, runny nose, itchy/infected ears, diarrhea, fleas, lice, intestinal worms, etc.

My Dog is over 18 weeks old and am NOT registering my Dog for Puppy Start Right.

REMOVAL FROM CLASS*

The Instructor may, at her sole discretion, remove you and your Dog from class if either of you is considered to be a threat of any nature to yourself or any person or animal present, or if you, despite repeatedly being asked not to, continue to use corrections, including, but not limited to, leash corrections, scolding, or shouting at your Dog. Such actions are counter-productive to the successful outcome of the training, and it may frighten not only your Dog, but also the other dogs in class, and it offends their owners and the Instructor. No refund will be given under such circumstances.

SCHEDULE OF CLASSES & HOMEWORK*

The class schedule is available through our website, where it will be updated from time to time – so please check in regularly! Please use the schedule to plan and book your class attendance. Students are expected to complete homework in between each class in order to progress to graduation level.

TRAINING EQUIPMENT*

Electric shock collars, choke chains, prong collars and any other corrective implements are not conducive to modern dog training and are EXPRESSLY PROHIBITED from our classes. If a muzzle has been prescribed for your reactive Dog, this must be worn at all times when at the training centre and surrounding areas. Your Dog will then need to be conditioned to love to wear the muzzle.

LIABILITY WAIVER - 1*

The Owner/Handler agrees to indemnify and hold Cowichan Canine Behaviour & Training Ltd and/or Lisbeth Plant and/or any of their employees/agents (“Instructor”) harmless from any and all liability for any loss, damage, injury or illness to persons, animals or property, including if Dog causes an accident or property damage, or bites or injures any other dog, animal or person (including but not limited to Instructor), during or after the term of this Agreement.

LIABILITY WAIVER - 2*

Owner/Handler agrees that Instructor shall not be liable for any loss or damage for any reason unless said loss or damage was a direct and undeniable result of Instructor’s negligence. If Dog causes property damage, or bites or injures any other dog, animal or person during or after the term of this Agreement, then the Owner/Handler agrees to defend and indemnify Instructor and Instructor’s agents from any resulting claims, demands, lawsuits, losses, costs or expenses, including attorney fees. If Dog is injured in a fight or in any other manner during or after the term of this Agreement, the Owner/Handler assumes the risk and agrees that Instructor shall not be held responsible for any resulting injuries, losses, damages, costs or expenses whatsoever.

LIABILITY WAIVER - 3*

Client understands that socialization between animals, whether on or off leash, is always dependent on the polite behaviour of all parties involved, and that accidents may happen at any time. Likewise, although Dog may have performed satisfactorily on the recall exercises in class, Client understands that there is always a risk that a dog may be distracted and run away, and also that participation in a Playgroup is no ‘safer’ than walking your dog on or off leash in any other circumstances. Client agrees to assume full responsibility for any actions of Dog or Client, and for the consequences of any actions by other dogs or animals or people affecting Dog or Client, and that Cowichan Canine and/or Cowichan Canine’s agent will be held free of any resulting claims, demands, lawsuits, losses, costs or expenses, including attorney fees, associated with any actions by Dog or Client, or affecting Dog or Client.

LIABILITY WAIVER - 4*

Please use your common sense and judgment when it comes to where and when you let your dog off leash, and when deciding with which dogs and people you should let your dog interact. If there are ever children, horses, cats or other animals or other individuals nearby, please put your dog on leash. Do not trust your dog's or any other animal's or person's safety to your ability as a dog trainer.

PANDEMIC WAIVER*

Each time the Owner/Handler attends Cowichan Canine’s premises, he/she declares him/herself and all other persons accompanies the Owner/Handler to class to be in compliance with Cowichan Canine’s from time to time published Health Declaration and Safety Plan regulations (available on https://cowichancanine.ca).

SCOPE*

This Agreement is binding upon the Owner/Handler, and the members of the Owner's/Handler's family and household.

TERMINATION*

Cowichan Canine 's duties hereunder shall terminate if (a) in an Instructor's sole judgment Dog is dangerous or vicious to Instructor or any other person or animal, or interferes with the training of other dogs, or (b) the Owner/Handler breaches any term or condition of this Agreement or (c) either party cancels the Agreement. Upon termination in accordance with the foregoing, Instructor's duties shall terminate but all other provisions of this Agreement shall continue in full force and effect.

VIDEO & PHOTOGRAPHY WAIVER*

The Owner/Handler grants Cowichan Canine the permission to obtain and use photographic and video graphic images of the Dog and Owner/Handler during their participation in its programmes and activities.

No permission granted.

REGISTRATION PROCESS*

Complete and submit this form.

Email your dog's vaccination certificate to info@cowichancanine.ca

Submit your payment

VACCINATION RECORD*

I have emailed my dog's vaccination or titer certificate to info@cowichancanine.ca

Vaccination certificate must be no older than three years.
Titer certificate must be no older than one year.

Please indicate date and method of payment:*

If you do not yet know which class to sign up for, please enter "TBD".

Please enter today's date in format YYYY-MM-DD*

Format: YYYY-MM-DD

SIGNATURE - By typing your full name in this box and then submitting the form to us, you are signing this registration form and warrant that you have truthfully answered all questions and read and understood all conditions in this form.*