PRIVATE LESSON INTAKE FORM - sumacgrant-johnson.com

Thank you for scheduling your private lesson.

Please fill out the form below. This information is important to help me be as prepared as possible and help you to get the most out of your appointment.
Please bring a large supply of small soft treats that your dog enjoys. A minimum of 1 cup. I suggest reducing the meal you serve your dog prior to the lesson since we will use a lot of treats during the session.

I look forward to working with you and your dog.

Sumac

Date/Time

Please enter the date and time of your appointment.

Dog Owners Name *

First

Last

Email *

Phone *

Please include a phone number that we can reach you in the event of a class cancelation.

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Dog's Name *

Dog's breed or best guess *

Dog's age or best guess *

Multiple Choice *

Male - Neutered
Male - Not Neutered
Female - Spayed
Female - Not Spayed

TRAINING GOAL 1 *

My number one priority for this session is. Please include any applicable history.

TRAINING GOAL 2 *

My number two priority for this session is. Please include any applicable history.

TRAINING GOAL 3 *

My number three priority for this session is. Please include any applicable history.

Aggression Policy *

I have read and agree to the aggression policy

AGGRESSION - MY DOG HAS NO KNOWN HISTORY OF AGGRESSION. THIS INCLUDES ANY INCIDENTS OF NIPPING, GROWING, SHOWING OF TEETH, LUNCHING OR INTENT TO DO HARM. (Puppies under 5 months of age may exhibit mouthing and playful grabbing and growling and is not considered aggression) Please contact Sumac prior to registering if this is in question. I UNDERSTAND THAT IF MY DOG SHOWS ANY SIGNS OF AGGRESSION THAT I MUST REMOVE MY DOG TO A SAFE LOCATION AND THE APPOINTMENT WILL END IMMEDIATELY. NO REFUND WILL BE OFFERED.

Wellness Policy *

I have read and agree to the wellness policy

WELLNESS POLICY- My dog is healthy and free of parasites. My dog is current with state required vaccinations. (Puppies may not be and are not required to be fully vaccinated due to age and veterinary recommendations). ILLNESS -I will notify Sumac before our appointment if my dog is showing any signs of illness (including coughing) parasites or fleas.

Payment Policy *

I understand payment is expected at the start of my appointment. Payment may be in the form of cash or Venmo.

Release and Waver *

I have read and agree to the Release and Waver

I understand dog training is not without risk. I (we) agree to hold Wag It Inc., Sumac Grant-Johnson, officers, directors, agents and any employees of the aforementioned parties harmless from any claim or loss or injury. I (we) personally assume all responsibility and liability for any such claim. I (we) hereby assume the sole responsibility for and agree to indemnify and save the aforementioned parties harmless from any and all loss and expense, including legal fees.

Photo/Video Policy

I understand and agree

I understand that any photos and/or videos I take during my appointment are for my own personal use and may not be published in any form anywhere.

How did you hear about Sumac

Please be specific - A friends name, an email forum, social media etc.

Questions Comments

Directions - For In home lessons only

I appreciate information to help me Identify your home. Thank you

Phone