Dog Training Nashville

Membership Release Form

Name

First

Last

Phone

Address

City

State/Province

Zip/Postal

Country

Emergency Contact

Emergency Contact Phone

Dog's Name

Breed

Age

Sex

Male

Female

Spayed/Neutered

Yes

Veterinarian

Veterinarian Phone

Pet Care Authorization and Release:

Nikki Ivey, DogSpeak and its employees/contractors will keep the premises sanitary and properly enclosed and will exercise reasonable care for the safety and well-being of your dog. 

DogSpeak and its employees/contractors cannot be liable for damage or loss by or to dogs in your home.  

Owner understands the concept of pet sitting, the DogSpeak Membership and positive training techniques.  

Your dog(s) may participate in supervised activities related to training.  While DogSpeak will exercise extreme caution and discretion with the training and care of your dog(s), there is always a possibility of injury resulting from travel or other dogs and/or humans, either in the home or at a public location. 

Owner agrees that any injury/illness to their dog during the DogSpeak Membership shall not bring any liability of any type on the part of Nikki Ivey, DogSpeak and/or its employees/contractors.   

Owner agrees to inform DogSpeak if the dog is showing signs of any illness or physical limitation that may affect training, or behavioral issues that may result in harm or illness to humans or other dogs. 
 
Nikki Ivey, DogSpeak and its employees/contractors are authorized by the owner to seek veterinary care, including emergency care, at the owner’s expense. DogSpeak will attempt to contact you before obtaining any care; however, this form serves as the authorization Nikki Ivey, DogSpeak and its employees/contractors needs to obtain veterinarian care for your dog regardless. The owner is responsible for veterinarian expenses and transportation, whether or not the owner was reached in advance.  

The owner agrees to pay all charges for the DogSpeak  Membership. 

DogSpeak employees/contractors may film parts of your dog’s training for educational purposes.  By signing this release, you authorize DogSpeak to film your pet.  No compensation will be given to dog owners for video and/or photos. 
  
I HAVE READ, UNDERSTAND, AND AGREE TO ALL THE PROVISIONS OF THIS AUTHORIZATION. I will notify Nikki Ivey DBA DogSpeak of any changes to Membership information and assume full responsibility for any additional charges. The owner hereby agrees to waive and release Nikki Ivey, DogSpeak and its employees/contrators from any right that you may have in law to recover medical payments, bodily injury damages, or property damages for any liability regardless of the cost, as a result of any injury resulting from the actions of my dog, any other dog, or any humans. I hereby agree to the pet care authorization form as the owner of the dog. I also certify that my dog(s) is/are in good health and do not show any signs of illness that may be contagious or cause harm to humans or other dogs. Furthermore, I certify that all the information provided about my pet(s) is accurate to the best of my knowledge. I have read, understand, and agree to all the provisions of this form.

I have read and agree with the terms of the Pet Care Authorization and Release

I agree

I disagree

Electronic Signature (Please type your full name)

Date

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