Colin's Pack

Client Information

First Name *

Last Name *

Email Address *

Phone Number *

Dog's Name *

Dog's Breed *

Dog's Gender *

Male

Female

Is your dog neutered/spayed *

Neutered/spayed

Not neutered/spayed

Dog's approximate age? *

Dog's approximate weight? *

Primary problem(s)

Aggression

Fear

Anxiety

Separation Anxiety

Other, or more info (you will have an opportunity to elaborate in another answer box below) Other, or more info (you will have an opportunity to elaborate in another answer box below)

Was he/she

How long have you had the dog?

He/She

tends to be extraverted with people

tends to be extraverted with dogs

tends to be introverted with people

tends to be introverted with dogs

Other, or more details Other, or more details

Any traumatic experiences your dog has had that are still affecting his/her behavior?

Not that I know of

Yes Yes

Please describe what's going on with the dog relative to behavioral problems *

Any other noteworthy behaviors?

How would you describe your dog?

More of a dominant, assertive, confident, stubborn dog

More of a cautious timid, nervous, sensitive dog

Mostly well balanced, not timid, but not overly assertive

More of a defensive, alert dog, concerned about his/her safety. (This can be common with dogs who have been on the street or on their own)

Other, or more info Other, or more info

Previous socialization experience? Please check all that apply.

Does your dog tend to stick with you when off-leash? (though they may seem unnecessary, these questions can help paint a better picture of the situation)

Usually wants to be with me/the group

Likes to keep an eye on me/the group, but will go out ahead, or lag behind, but come back to check in

Will play games when I try to get him/her that make me a bit nervous

I don't trust that he/she will stay with me if off-leash

other, or more info other, or more info

Has your dog ever run away from you or your home?

No

Yes, once

Yes, more than once

If yes, could you briefly explain what happened? (This helps us get an idea of the mindset of the dog, please also feel free to share if you think they've changed since then.) If yes, could you briefly explain what happened? (This helps us get an idea of the mindset of the dog, please also feel free to share if you think they've changed since then.)

Upload photo of your dog (optional)

Street Address *

Address Line 2

City *

State *

Zip Code *

How you heard about us?

Emergency Contact Information

Emergency Contact

Phone Number

Secondary Emergency Contact

Phone Number

Release Of Liability

*We apologize in advance for the legal language. Thank you for understanding.

Client's Name (hereinafter referred to as "The Client") *

Dog's Name (hereinafter referred to as "The Dog") *

Note: Colin’s Pack services include but are not limited to picking up, driving, walking, hiking, and dropping off The Dog.)

This Agreement is between Colin’s Pack, Inc., a California corporation deletion (hereinafter referred to as “Colin’s Pack”).

Policies and Procedures:

1. The Client understands while participating in Colin’s Pack services, The Dog may be transported, walked on or off leash, and may have interaction with other dogs, people, and wildlife, including rattlesnakes, and that utilizing Colin’s Pack's services may expose The Client or The Dog to risks of serious personal injury, property damage, and even death.

2. The Client expressly agrees on behalf of The Client and The Client’s heirs, executors, administrators, successors, and assigns, Colin’s Pack shall not be liable, and The Client will not sue Colin’s Pack, for any injuries or damages, whether to The Client, The Dog, or The Client’s representatives, if any, arising in conjunction with Colin’s Pack’s services, regardless of whether such injuries result, in whole or in part, from any negligence, act, omission or fault of Colin’s Pack. The Client, on behalf of The Client and The Client’s heirs, executors, administrators, successors and assigns, fully and forever releases Colin’s Pack from any and all claims, present or future, and expressly waives the protection afforded by any statute, including California Civil Code section 1542, which provides a general release should not extend to claims unknown, anticipated, or unanticipated. The Client has read the foregoing waiver and release of liability and voluntarily executed this document with full knowledge of its content.

3. By signing this agreement, The Client, on behalf of The Client and The Client’s heirs, executors, administrators, successors and assigns, accepts and assumes full responsibility for any and all injuries, damages, (both economic and non-economic), and losses of any type, which may occur to anyone or any entity in conjunction with the participation of The Client, The Dog, and The Client’s representatives, if any, in Colin’s Pack’s services and hereby further agrees to indemnify and hold Colin’s Pack harmless against any and all such injuries, damages, and losses.

By signing below, The Client fully understands and agrees to the provisions of this Agreement.

Client's Signature: *

clear

Date * +

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