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If you have chosen to not vaccinate your dog, please complete the following form and waiver.
Note: by doing so, you accept full responsibility for any transmission of illness.
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Indicates required field
Name
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First
Last
Email
*
Address
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Phone Number
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Dog's Name
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Who is your dog's veterinarian? (clinic name and vet name)
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Is your dog up to date on vaccinations?
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Yes
No
Does your dog have a current titre or other antibody test? If yes, please state the date of the test.
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Is your dog on any medications or supplements? Please list.
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Has your dog experienced any communicable illness or disease? If yes, please list the illness and dates.
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Has your dog ever been vaccinated? Eg. puppy vaccinations. If yes, when was this?
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Waiver, Assumption of Risk, and Hold Harmless Agreement
I understand that my decision to not vaccinate my dog is not without risk.
I hereby waive all claims for damage and release and forever discharge Dogwit Training Inc., their directors, officers, employees, assistants, volunteers and representatives from any and all claims, damages, losses, or liabilities of any nature, for injury, illness, or damage which my dog may suffer in connection with my participation in training services offered by Dogwit Training Inc., including specifically, but not without limitation, any illness contracted by participation in a group class. I expressly assume the risk of such damage, illness, or injury when participating in any training session or other function.
Do you understand and agree to the terms outlined in the above Waiver, Assumption of Risk, and Hold Harmless Agreement?
*
I agree
Submit
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Separation Anxiety
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