LUCKY DAWG CLASS REGISTRATION

YOUR INSTRUCTOR FOR THIS CLASS: DEBRA MOODY, B.A., CPDT-KA, CDT
DEBRA MOODY, B.A., CPDT-KA, CDT is a certified professional dog trainer-knowledge assessed; graduate and certified dog trainer of Animal Behavior College; an authorized Animal Behavior College mentor trainer; a professional member of the Association of Pet Dog Trainers; an AKC Canine Good Citizen® evaluator; and a professional member of Behavior Education Network.

By providing convenient in-home training, Debra helps clients create solutions to fit their needs and busy schedules. She stays up-to-date with current training methods and practices by attending workshops, conferences, seminars and webinars both locally and nationally. Debra volunteers her time working to help dogs become adoptable and find their forever homes at Rasta's Rescue Ranch and teaches group classes at Lucky Dawg Daycare and Training Center. Training and teaching keeps her active along with a black Lab named Tess, and a chocolate Lab/mix rescue named Ruby. While she's never met a dog she hasn't liked, she readily admits that Labrador's have a special place in her heart!

GROUP CLASS LIABILITY RELEASE AND AGREEMENT
By completing the form below, I certify that I have read and understand the following:
Lucky Dawg Daycare and Training Center, its employees and agents, and Debra Moody work to ensure the safest learning and training environment possible for people and dogs. However, I understand that dog training is physical in nature for both human and canine participants, and while all precautions will be taken against such incidents, there are inherent risks involved in dog training therefore, injury can result to humans and/or dogs on occasion.

I, the undersigned owner/handler of the dog described above, do hereby agree to indemnify and hold harmless Lucky Dawg Daycare and Training Center, it's employees, representatives and agents, and Debra Moody for any injury, cost, expense, damage or loss resulting from failure of the dog, it's owner(s)/handlers(s) and/or guests to respond to any training resulting from or reference to instruction, counseling, and advice supplied to the owner(s)/handler(s) and/or guests. The dog's behavior now and in the future; both in and outside the class; is solely the responsibility of the owner(s)/handler(s) of the dog. In addition, should any behavior on the part of the dog or owner(s)/handler(s) now or in the future; both in and outside the class; result in injury, cost, expense, damage or loss to the property, or person(s) of some third party, the owner(s) agree to assume full responsibility for any and all such injury, cost, expense, damage or loss , and to absolve Lucky Dawg Daycare and Training Center, it's employees, representatives and agents, and Debra Moody from any and all liability and/or obligation to pay such damage to owner(s)/handler(s) and/or third party.

I understand and agree that in admitting my dog to training classes, Lucky Dawg Daycare and Training Center, its employees, representatives and agents, and Debra Moody have relied on my representation that my dog is in good health and has not harmed any people and/ or dogs. Dogs exhibiting aggressive or reactive behavior such as, but not limited to lunging, biting, air-snapping or staring down other dogs or people will not be permitted in class. Participation of my dog in training is at the discretion of Lucky Dawg Daycare and Training Center and Debra Moody. If it is determined that my dog is not ready for a group class setting, Lucky Dawg Daycare and Training Center and Debra Moody reserve the right to expel my dog from training as they deem necessary to ensure the safety of any and all participants.

I understand and agree that any and all video and photos taken during class with Lucky Dawg Daycare and Training Center and Debra Moody can be used for instructional and marketing purposes.

I acknowledge that I have read, understand, and agree to accept and abide by the rules, responsibilities, policies and procedures of Lucky Dawg Daycare and Training Center and Debra Moody for class registration, payment, participation, refund, class attendance, course cancellation, children in class, and safety as set forth in this agreement.


>> Please read our Class Registration and Payment Information regarding refunds, attendance, course cancellation, children in class, and our safety policy before registering for a class online.

REGISTRATION FOR CLASS WITH DEBRA MOODY, B.A., CPDT-KA, CDT

Class Name, Date, and Instructor
Owner's Name
Dog's Name, Breed, Sex, Weight, and Age
Dog's Age When Spayed or Neutered
Home Address
Home Phone
Email Address
Veterinarian Name/Phone
Names of additional family members/guests attending class: Please note - children under 10 years of age must be attended to by an adult other than the dog handler.
Do you or your dog have any medical or physical limitations we should allow for in this class? If yes, please describe.
Dog's name:
Dog's breed or mix:
Age of dog when acquired (or best guess):
Dog's current age (or best guess):
Dog's sex:	Neutered Male Spayed Female Unaltered Male Unaltered Female
Where did you get your dog?
Are there additional family members in your home? If yes, please list names and ages.
Do you have other pets? If yes, please list species and ages of pets.
Is your dog up-to-date on his/her vaccines? Please bring a copy of your dog's current vaccination records to the class orientation.
Has your dog had prior training? If yes, where/with whom/what type(s) of training?
Has your dog ever displayed aggressive behavior toward people? If yes, please describe incident(s).
Does your dog show fear, aggression, or protectiveness? If yes, please describe incident(s).
Has your dog ever bitten you or another person? If yes, please describe incident(s).
Has your dog ever displayed aggressive behavior toward other dogs? If yes, please describe incident(s).
Has your dog ever bitten another dog? If yes, please describe incident(s).
What are your goals for this class?
List any additional training or behavior challenges with your dog.
Required: How did you hear about Lucky Dawg Daycare?
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