Online Training Preliminary Registration - Positive Results Dog Training's Home School for Dogs

Owner's Information
Pet Guardian's Name (First AND Last)*
Address, Line 1 (include complete street address and apartment number)*
City and State*
Zip Code*
Virtual Contact Information
Best Phone Number for Contact*
Is this number a mobile number that can receive texts? (Yes or No)*
E-Mail (required for online classes)*
Alternate E-Mail
About Your Dog
Pet's Name*
Breed (use "mixed" or "unknown" if applicable)*
Current Age of Dog (use best estimate if unknown)*
Program Selection
I am interested in:*	Initial Remote Consultation for Behavior Issues: Single Session ($100) Follow-Up Remote Session (Behavior Issues): Single Session ($85) Remote Session - General Training / Manners Only: ($80)
Release to Participate (electronic signature required in box below)
I understand that the activity of dog training includes an element of risk to my dog, myself and others around me. I further understand that there can be no guarantees about my dog's behavior now, throughout my participation in this course, or in the future. By agreeing to contract for online and/or in-person training services, I agree to waive, release and forever discharge Nancy S. Fitzgerald and Positive Results Dog Training LLC from any claims or liability of any kind whatsoever arising out of my participation in this course.
Optional Waivers (please check as warranted)
Positive Results Dog Training may:	Use videos of me or my dog for promotional purposes without liability or obligation to me. Use comments made in writing as testimonials in future advertising.

Owner's Information

Virtual Contact Information

About Your Dog

Program Selection

Release to Participate (electronic signature required in box below)

Optional Waivers (please check as warranted)