Registering with check

"*" indicates required fields

Course Information

Registering for*

Start Date*

Start Time*

Please describe your goals for taking this course and any problem behaviors.*

Have you and your dog have any prior training?*

Yes

Where and what philosophy was used?*

Student Information

Name*

First Last

Address*

Street Address City State zip

Email*

List all phone numbers where you can be reached*

Phone number

Type

Child also attending with you

Name of Child

Age

Please specify any special needs of the attendees that we should be aware of:

Dog Information

Name*

Breed*

Date of Birth*

Age*

Weight*

Gender*

Male

Female

Neutered*

Yes

Spayed*

Yes

How long have you had your dog?*

If you adopted, please specify where.

What on-leash behaviors are you looking to address?*

What type of collar/harness does your dog currently wear on walks?*

Does your dog bark or lunge at other dogs while on a walk?*

Does your dog bark or lunge at other humans while on a walk?*

Does your dog bark or lunge at cars/bikes/skateboards/rollerblades while on a walk?*

Does your dog have a bite history (e.g., has bitten/attacked another dog/human while on a walk 'or on- or off-leash in any situation')?*

Please list any allergies:

Are there any health or other concerns we should be aware of?

Your Veterinarian

Name of Veterinarian*

Address*

Street Address Address Line 2 City State ZIP

Phone*

Vaccinations: Bark n’ Roll follows the American Veterinary Society of Animal Behavior’s Position Statement on Puppy Socialization:
“In general, puppies can start puppy socialization classes as early as 7-8 weeks of age. Puppies should receive a minimum of one set of vaccines at least 7 days prior to the first class and a first deworming. They should be kept up-to-date on vaccines throughout the class.”
Please refer to the AVSAB website for full statement and more information on puppy socialization.

Adult dogs must have proof of an up-to-date Rabies vaccine as well as the Distemper combo.

The Bordatella (kennel cough) vaccine is not required by BnR. Please inform your veterinarian that you will be attending group dog training classes and follow his or her advise regarding this vaccine for your dog.

Upload documentation for Distemper/Parvovirus and Rabies vaccines.

Max. file size: 100 MB.

You can also mail or bring documentation to first class.

Training Agreement

Bark n’ Roll hereinafter known as “the Company” cannot make any guarantee regarding the outcome of any training/counseling program. The student assumes full responsibility for the dog’s behavior during and after the training/counseling program.

The student may have the animal withdrawn from training at any time, however, once payment has been made, all fees are non-refundable.

The student is required to work the dog(s) 7 to 12 times a week on strengthening all cues taught. The reinforcement can be accomplished in approximately 20 to 30 minutes per day per dog.

THE STUDENT UNDERSTANDS AND AGREES THAT THEY ARE BEING TRAINED TO TRAIN THEIR DOG(S) AND THAT WITHOUT 100% COOPERATION WITH THE TRAINER, THE DOG(S) WILL NOT GET TRAINED.

Missed Group Class Policy

Group classes are progressive, including a review of the prior week’s exercises and new skills being introduced every week. Missing class causes you and your dog to be behind in the curriculum. There are no make-up classes available for missed classes. However, you will still receive the homework. In order to get the full benefits of class, your regular attendance is crucial. If your dog is ill, you are encouraged to come to class without your dog to observe the training that day and get the week’s homework or if you are unable to attend in person, you may request to attend via Zoom. You will have the option to schedule a 30 min private session with your instructor for 1 missed class at the class rate of $60. If your dog misses 2 or more classes, you will be required to re-register and start again, or schedule a full hour private session at the current private lesson rate of $125 with your trainer to catch up on the skill before re-attending your class allowing you and your dog to catch up before continuing on. If we have to cancel the class for any reason, we will offer a makeup class date and will apply your payment to the new class date. No refunds will be given for missed classes.

Liability

Checking the box below indicates that I, as the legal owner/agent of the abovementioned pet(s), having carefully read and fully understand this agreement, do hereby waive and release the Company/Francine Coughlin and its associates from any and all liability of any nature. This includes any injury, death, sickness or damage my pet may suffer during or after any training program. I also agree to indemnify and hold harmless the Company/Francine Coughlin and its associates from any and all claims due to damage the pet may cause to any family members, pets or property of any third parties during or after training.

I HAVE READ AND UNDERSTAND THAT ALL TRAINING IS CONTINGENT UPON THE STUDENT’S WILLINGNESS TO HANDLE AND / OR WORK THE DOG(S) AS DESCRIBED ABOVE.

Amount due