Registration Form

20 __ Results Puppy & Dog Training - Pawformance Dog Sports
Trainer Information, Rules & Waiver

NEW? Bring a copy of your pet's health record for my file and this completed two page form to your first class. No printer? Blank forms are available at class, arrive 15 min. early to complete. There is a 'no refund policy' if less than two days notice before class start, unless the instructor. FMI, visit my home page here: Results - Pawformance Puppy & Dog Classes

Owner-Trainer Name:                           	Pet Name & Birthdate:

Street Address:                               	Breed(s):            

City:       		      Zip:              Male Neutered - Y  N 

Phone(s):                                     	Female Spayed - Y  N

E-mail (private):

Referred by:					Vet. Clinic:

Length of ownership:       			Acquired from:


Use the back of the form if more room is needed for the Q.'s below.

Household Members & Other Pets:               	

Emergency Contact & Phone / Health Alert for people or pet? If yes - explain

Have you attended a class with this and/or other dogs? If yes, when and where?

List what pet knows: Term or command, teaching method(s) and equipment used.

Describe your pets' temperament.

Has your dog ever shown aggression? NO YES If yes, please explain.

List your goals and help desired.


Class Name          Brighton or Howell        Start     End     Time        Fee

Rules & Hold Harmless - Liability Risk Waiver
Mary T. Ratelle, Results Puppy & Dog Training Classes, Pawformance Dog Sports, Brighton Community Education/Brighton Area Schools and/or Cohoctah Township, MI:
Our main concern is safety, an educational and enjoyable experience for all participants! If a rule or statement is not clear, inquire!
1. Trainer noted below must be eighteen years of age or older to particpate in all offerings unless advertised otherwise. Trainer or parent/guardian if trainer is under 18 years of age will provide a drivers license or state ID card at first class.
2. Be courteous, have your pet clean and brushed prior to arriving to your class or lesson. No grooming on grounds.
3. The instructor reserves the option to terminate training at any time if a trainer, guest or pet interferes with normal class flow or does not follow rules. Aggressive dogs will not be allowed to participate and trainers not following direction will be dismissed without refund.
4. No media capture, picture taking, electronic or video taping of any type is allowed without written permission and if allowed, any media capture must be provided to for file and approved by Mary T. Ratelle prior to publishing or posting.
5. Wolf, wolf-hybrids or canine(s) that have been or are in guard or attack training are not accepted.
6. Health record showing current rabies vaccine is required for every pet accepted for training that is over six months of age per MI law.
7. Female dogs are not allowed to particpate during their heat cycle and must be bathed priot to class return. No refunds will be given, private or floor time lessons for an additonal fee may be available-inquire.
8. Trainer accepts full responsibility for his or her actions, pet(s) and guests(s) in attendance and when on training grounds.
9. Training success depends on many factors, THUS NO GUARANTEES ARE IMPLIED.

AGREEMENT TO HOLD-HARMLESS WAIVER AND ASSUMPTION OF RISK: I, the undersigned participant, hereby take action for myself, my executors, administrators, heirs, next of kin, successors and assign to: (A) waive, release, and discharge from any and all liability for my death, disability, personal injury, property damage, property theft or actions of any kind which may hereafter accrue to me including as to my traveling to and from any events or while training at my home, the following entities or persons: Results Dog Training, Pawformance Dog Sports!, Mary T. Ratelle, her employees, volunteers, representatives and agents and others working or acting on her behalf, Brighton Area Schools/BCE, Cohoctah Township, MI and to the extent permitted by law (B) indemnify and hold harmless the entities or persons mentioned in the paragraph from any and all liabilities or claims made by other individuals or entities as a result of or relating to my attendance at or participation in any events or lessons by Mary T. Ratelle, her volunteers and guests and assume all responsibility for my, any person(s) in attendance with me and my canines participation. I hereby certify that I and my canine are physically fit for participation in events and lessons. I have read this document and understand its contents and the conditions of training with Mary T. Ratelle, Results Puppy & Dog Training and/or Pawformance Dog Sports including but not limited to all locations.

TRAINER________________________________________ DATE OF BIRTH________________

MAILING ADDRESS_____________________________________________________________

Driver License #________________________________________ Phone(s):

SIGNATURE:__________________________________________ Date:_____________