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New Client Form
If you are a new client, please fill out and submit this form BEFORE signing up for your first class.
Your Full Name(*)
Please type your full name.
E-mail(*)
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Client Information

Street Address(*)
Please enter your address
City(*)
Please enter your city
State or Province(*)
Please enter your state or province
Zip or Postal Code(*)
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Home Phone(*)
Please enter your phone number
Work or Cell Phone
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Occupation
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How did you hear about us?
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Vet's Name
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Vet's Phone
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Have you trained a dog before?
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If so, where and when?
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Have you done clicker training?
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New Dog Information

Use this page to tell us about ONE dog. You can add another dog on the next page.
Dog's Name(*)
Enter your dog's name
Dog's Date of Birth(*)
Enter dog's date of birth
Breed(*)
Enter breed of dog
Sex(*)
Check M or F
Spayed/Neutered(*)
Check yes or no
Where did you obtain this dog? (please be specific)(*)
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Is your dog friendly with people?
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Is your dog friendly with other dogs?
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Is your dog housetrained?
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Is your dog crate-trained?
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Does your dog have any physical problems?
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Does your dog have any problems you would
like to discuss with a trainer?
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Rabies Expiration Date
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Rabies Tag #
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About Dog 2

If you have no more dogs to add, just leave this blank and continue to the next page.

If you have more than 2 dogs you'd like to enter into our system, please fill out this form again with your 3rd (or 4th and so on) dogs. You can skip the first page after name and e-mail address.

Dog's Name
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Dog's Date of Birth
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Breed
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Sex
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Spayed/Neutered
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Where did you obtain this dog? (please be specific)
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Is your dog friendly with people?
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Is your dog friendly with other dogs?
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Is your dog housetrained?
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Is your dog crate-trained?
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Does your dog have any physical problems?
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Does your dog have any problems you would like to discuss with a trainer?
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Invalid Input
Rabies Expiration Date
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Rabies Tag #
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WAIVER, ASSUMPTION OF RISK, AND AGREEMENT TO INDEMNIFY AND HOLD HARMLESS

I understand attendance in a dog training class is not without risk to myself, members of my family or guests who may attend or to my dog because some dogs to which I (we) will be exposed may be difficult to control and may be the cause of injury even when handled with the utmost care.

I hereby waive and release SureFire Dogs, Inc. it employees, owners and agents from any and all liability of any nature for injury or damage which I or my dog may suffer, including specifically, but not without limitation to, any injury or damage resulting from the action of any dog, and I expressly assume the risk of any such damage or injury while attending any training session or other function of SureFire Dogs, Inc. or while on the training grounds or the surrounding area.

I hereby agree to indemnify and hold harmless SureFire Dogs, Inc., its employees, owners, and agents from any and all claims, or claims by any member of my family or any other person accompanying me to any training session or function of SureFire Dogs, Inc. or while on the grounds or the surrounding area as a result of any action by any dog, including my own.

I understand that my payment with my online class registration will hold my place in class. I understand there are no refunds after the first class.

By submitting the form you are agreeing to this waiver.

Please type the characters you see in the box.(*) Please type the characters you see in the box.
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