Puppy Class Waiver Form Puppy Class Waiver Owner's Name * Owner's Name First First Last Last Owner's Address * Owner's Address Owner's Address Owner's Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Owner's Phone * Owner's Email * Patient Name * Patient Age * Patient Weight * I hereby acknowledge that I have voluntarily agreed to participate in puppy training activities at LVC. I acknowledge that the dog being trained will follow the Puppy Class guidelines per LVC protocol which include the following A exam by Doctor of Veterinary Medicine 1st DHPP vaccine, and Oral Bordetella Has received vaccines no less than 10 days prior to starting class Vaccines must have been given by Doctor of Veterinary Medicine( Vaccines from Breeders or Tractor Supply with not be accepted) Preventions must be started and continued through classes Your pet must stay current on vaccines through classes. Signature * signature keyboard Clear I am aware that there are inherent risks and hazards involved in activities with and around dogs, and I am voluntarily participating in these activities with knowledge of potential dangers. I am aware that any dog, regardless of training, handling, or environmental circumstance, is capable of biting, and I expressly acknowledge the risks therein. In addition, there may be a potential for slips/falls/injury/escape from the training area while on hospital property. In order to participate in puppy training classes or other activities, I am fully informed of such risks and hazards, and agree to assume all risks of such circumstances. Signature * signature keyboard Clear I hereby waive any and all claims or actions that I or my guardians, heirs or legal representatives may have, from any and all personal injury to myself, my dog, children in my charge or harm to property or person caused directly or indirectly, through action or inaction of self or others, by acts that might occur in training classes without trainer present. Signature * signature keyboard Clear I agree to indemnify LVC and its owners and employees from any and all claims by myself, family members, or any agent while within training facilities, within my home property, or in the general public as a result of any action or inaction, of either my dog or any other dog now and in the future. Signature * signature keyboard Clear I agree that if my dog is ill or comes to class ill and is deemed "unwell" or "unhealthy" they will not be able to attend class that day. Signature * signature keyboard Clear I also agree to assume sole responsibility for injury or damage caused by myself, children in my charge, or by the dog I own or handle and further agree to indemnify, defend and hold the trainer(s), owners and other employees and hospital harmless from any damage, loss, liability or expense, including legal cost and attorney's fees which result from damage caused by myself, children in my charge, or by the dog I own or handle. Signature * signature keyboard Clear LVC may use pictures of me or my dog for promotional purposes without liability or obligation of any kind to me. Signature * signature keyboard Clear I hereby acknowledge payment is final, and there are no refund for unused or missed classes. Signature * signature keyboard Clear I have read the waiver and agree to adhere to the above policies. I understand that if I am bringing any children under the age of 10yrs that they need to have an adult present for the child as well as an adult present for the puppy. Signature * signature keyboard Clear Date * Captcha Submit If you are human, leave this field blank.
