Building Great Recalls | Clubhouse for Dogs

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When you sign up, you will receive an email confirmation of your payment by Paypal; a Paypal account is NOT required and you can use your credit or debit card. The Clubhouse for Dogs will send you a personal confirmation email with further information and class instructions 5 days prior to the start of class.

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Your Information

Your First Name *

Last Name *

Street Address *

City *

State *

Zip Code *

Your Email *

Cell Phone *

Dog Information

Name *

Breed *

Age *

Gender *

Veterinarian Name *

Veterinarian Phone *

Vaccination Records

Can you provide records for the following vaccinations?

DHPP * NoYes

Bordatella * NoYes

Rabies * NoYes

Referral

How did you hear about us? *

Name (so we can thank them!)

* LIABILITY DISCLAIMER: * I herewith certify that my puppy/dog has NEVER caused harm to another animal or person. Any behavioral problems must be discussed with Pascale Fortmann prior to enrolling in a program at Fuda/Fortmann, LLC DBA The Clubhouse for Dogs. I understand that participating in The Clubhouse for Dogs programs (group classes, private sessions, specialty programs or training walks) involves risks of personal injury and/or property damage to myself, to my dog, and accompanying family members. I assume all risks associated with my dog’s enrollment in The Clubhouse for Dogs programs. I certify that my dog is current on all vaccinations. By signing this form, I hereby agree to indemnify and hold harmless Fuda/Fortmann, LLC DBA The Clubhouse for Dogs, Pascale Fortmann and their officers, directors, instructors, agents, employees, contractors and/or representatives of any and all claims, or claims by any member of my family, or accompanying guests of mine, regarding injury, expense, costs or damages to myself, my dog or any handler of my dog, arising out of or in connection with or in any way related to training walks, in home/studio sessions and/or training classes/sessions, even though the liability may arise out of negligence or carelessness on the part of the individuals or entities released in this Waiver and Release. In addition, I agree that I will defend and indemnify Fuda/Fortmann, LLC DBA The Clubhouse for Dogs, Pascale Fortmann and their officers, directors, instructors, agents, employees, contractors and/or representatives for any injury, expense, costs or damages to any dog handlers or dogs, to third parties arising out of my own actions or the actions of my dog. I agree that the risks of enrolling young puppies in The Clubhouse for Dogs programs have been fully explained to me, and I have been advised to consult with my veterinarian regarding health risks involved. I also understand that The Clubhouse for Dogs may use pictures of me and/or my dog for promotional purposes without liability or obligation to me. I have read, understand and agree to the above. We reserve the right to deny participation in any of our programs.