Grassroots K9 Shadow Program Participant Intake Form

First name

Last name

Phone

Address

Dog's Name

If you are bringing your dog to the program, please provide copies of their up-to-date vaccination records.

Do you own a business?

Yes

Company name

Business address

Why are you interested in participating in the 2-week shadow dog training program?

What specific skills or knowledge do you hope to gain from this experience?

How do you plan to apply what you learn during the program to your current or future dog training activities?

Are there particular areas of dog training you are most interested in observing or learning about?

Liability Waiver

I understand and acknowledge that participation in the Program involves inherent risks, including but not limited to, the risk of injury, harm, or loss associated with interacting with dogs and engaging in training activities. These risks include, but are not limited to, dog bites, scratches, falls, and other injuries that may occur from handling or being in the presence of dogs.

Signature

Signature field is empty.

Assumption of Risk

I voluntarily and knowingly assume all risks associated with my participation in the Program, including but not limited to, risks of injury, illness, or damage to personal property.

Release of Liability

I, hereby release, discharge, and hold harmless Grassroots K9, its owners, employees, trainers, agents, and representatives from any and all claims, demands, causes of action, or liabilities of any kind arising out of or in any way connected with my participation in the Program.

Compliance with Rules

I agree to comply with all rules, guidelines, and instructions provided by Grassroots K9 and its staff during my participation in the Program. I understand that failure to comply may result in my removal from the Program without refund.

Photography & Media Release

I consent to the use of photographs, video recordings, and other media taken during the Program for promotional, marketing, and educational purposes by Grassroots K9 without compensation.

Date picker

Signature

Signature field is empty.

1-888-991-GRK9

Grassroots K9 Shadow Program Participant Intake Form

Liability Waiver

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