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Registration Form
Step
1
of
4
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Your Personal Information
Owner's Name
(Required)
First Name
Last Name
Date of Birth (Owners must be 18 years of age to participate in class)
MM slash DD slash YYYY
Phone
(Required)
Email
(Required)
Address
(Required)
Street Address
City
State / Province / Region
Emergency Contact:
(Required)
Emergency First Name
Emergency Last Name
Emergency Phone
Pet Information
Dog’s Name
(Required)
Breed
(Required)
Birthday
(Required)
Age
(Required)
Gender
(Required)
Female
Male
Spay/Neutered
(Required)
Yes
No
Estimated Weight (lbs)
Colour/Markings
(Required)
Veterinarian
(Required)
Vet’s Phone
(Required)
Please list all medical conditions/ allergies/ medications.
(Required)
Vaccination Records
Please upload your up-to-date rabies vaccination records. Acceptable documents include a rabies certificate or a vet bill showing the rabies vaccination date. A clear picture or screenshot of these documents is acceptable.
(Required)
Drop files here or
Select files
Max. file size: 50 MB, Max. files: 3.
Pet Behavioral History
How does your dog behave around the following
Around other dogs
(Required)
Friendly
Shy
Fearful
Reactive
Agressive
Around other people
(Required)
Friendly
Shy
Fearful
Reactive
Agressive
Around Children
(Required)
Friendly
Shy
Fearful
Reactive
Agressive
Around loud noises (fireworks / vacuums / storms)
(Required)
Friendly
Shy
Fearful
Reactive
Agressive
When Handled (grooming / vet)
(Required)
Friendly
Shy
Fearful
Reactive
Agressive
Ever exhibited aggressive behavior (growling, snapping, lunging, biting) toward people or other animals? If yes, please describe the circumstances, frequency, and severity.
Training Goals & History
Does your dog knows basic commands (this means they execute the command after being told once)?
(Required)
Yes
No
Any specific behaviors you're struggling with? Examples include: jumping, leash pulling, barking, chewing, potty training, crate training, mouthing, separation anxiety, etc.
Previous training? When? What kind?
(Required)
What are your training goals? (e.g., better leash skills, reduce reactivity, general obedience, etc.)
(Required)
Comfort level with training tools (slip leads, prongs, e-collars, harnesses)
(Required)
What kind of training are you interested in?
Puppy Basics
Basic Obedience
Intermediate Life Skills
Advanced Reliability
Behavior modification
Private Training Sessions
Select All
Your Preferred Class Times
Select All
Weekday AM
Mid-day
Early Evening
Late Evening
Weekend
Flexible
Additional Information
Are you interested in extra services?
Nail Trims
Nutrition Counseling
Pet Photography
Select All
How did you hear about us?
In-store sign
Friend/Family
Social Media
Email
Additional things we should know about your dog’s background, personality?
DISCLOSURE & WAIVER
Acknowledgments & Agreements
Please check each box to acknowledge and agree:
Agree
(Required)
I Agree
(Required)
I certify that my dog is current on rabies vaccinations as required by NorthPoint Pets & the State of Connecticut.
Agree
(Required)
I Agree
(Required)
I certify that my pet is generally healthy and free from communicable (infectious) disease (e.g. kennel cough, leptospirosis etc.). I understand that if my pet becomes ill during a course in-progress, my pet and I will not be able to participate until my pet is no longer contagious. NorthPoint Pets will work with the client to make up classes and/or restart a future course.
Agree
(Required)
I Agree
(Required)
I certify that my dog is free from fleas and ticks and understands that any signs of infestations must be addressed before participating in training sessions. NorthPoint Pets & Company reserves the right to remove any dog displaying signs of fleas or ticks for the health and safety of all participants.
Agree
(Required)
I Agree
(Required)
I understand that I must upload a current copy of my dog’s vaccination records prior to the first class.
Agree
(Required)
I Agree
(Required)
My dog will not be allowed to participate without these records on file.
Agree
(Required)
I Agree
(Required)
I understand that fees paid for missed classes or programs are non-refundable.
Agree
(Required)
I Agree
(Required)
I understand that once my reservation is confirmed or classes have begun, no refunds will be issued for missed sessions or program withdrawals.
Agree
(Required)
I Agree
(Required)
I accept full responsibility for my dog’s behavior and any damage or injury caused during training sessions.
Agree
(Required)
I Agree
(Required)
I understand that NorthPoint Pets & Company reserves the right to remove any dog/owner from class who displays aggressive, unsafe, or disruptive behavior.
Agree
(Required)
I Agree
(Required)
I understand that the same person/persons must attend all classes with the dog to ensure consistency.
Agree
(Required)
I Agree
(Required)
I give permission for NorthPoint Pets & Company to photograph or record myself, my dog(s), and any guests during training sessions and visits to the store. I understand these materials may be used for promotional, educational, or marketing purposes and will become the property of NorthPoint Pets & Company.
Agree
(Required)
I Agree
(Required)
I release, indemnify, and hold harmless NorthPoint Pets & Company, its staff, contractors, and affiliated trainers from any and all claims, liabilities, losses, or damages arising from my participation, or my dog’s participation, in the training program.
Photo/Video Release & Liability Waiver
I acknowledge that I have read, understand, and agree to abide by the rules and conditions of NorthPoint Pets & Company’s training services. I understand that myself, my pet(s), and any guests may be photographed, recorded, or filmed during training sessions. I grant NorthPoint Pets & Company, its agents, and affiliates the unrestricted right to use and publish such media—without compensation—for educational, promotional, or marketing purposes in any format or platform. I waive any rights to inspect or approve the final use of these materials. I voluntarily agree to release, indemnify, defend, and hold harmless NorthPoint Pets & Company, its employees, contractors, and affiliated trainers from and against any and all claims, liabilities, losses, damages, injuries (including death), costs, or expenses—whether to persons, pets, or property—arising out of or relating to participation in any training activity or presence on company premises, whether caused by negligence or otherwise. This waiver applies to me, my pet(s), and any guests or individuals I bring to the premises. I have read and fully understand the terms of this agreement. I certify that I am voluntarily signing this waiver and release.
(Required)
I Agree
(Required)
I acknowledge that I have read, understand, and agree to abide by the rules and conditions of NorthPoint Pets & Company’s training services. I understand that myself, my pet(s), and any guests may be photographed, recorded, or filmed during training sessions. I grant NorthPoint Pets & Company, its agents, and affiliates the unrestricted right to use and publish such media—without compensation—for educational, promotional, or marketing purposes in any format or platform. I waive any rights to inspect or approve the final use of these materials.
I voluntarily agree to release, indemnify, defend, and hold harmless NorthPoint Pets & Company, its employees, contractors, and affiliated trainers from and against any and all claims, liabilities, losses, damages, injuries (including death), costs, or expenses—whether to persons, pets, or property—arising out of or relating to participation in any training activity or presence on company premises, whether caused by negligence or otherwise. This waiver applies to me, my pet(s), and any guests or individuals I bring to the premises.
I have read and fully understand the terms of this agreement. I certify that I am voluntarily signing this waiver and release.
Signature & Date
Signature
(Required)
Acknowledgement
(Required)
By typing my name above, I acknowledge that this serves as my legal signature. I agree to be bound by the terms and conditions outlined in this agreement for the training class indicated.
Date
(Required)
MM slash DD slash YYYY
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