Release Form

• RUN DAWG Contact & Dog Intake Form

  RUN DAWG currently services Las Vegas, Henderson, North Las Vegas and Summerlin NV. I, the undersigned, a customer of RUN DAWG (the “Company”), provide the following information about my pet(s) and certify that the information is true and up to date: Please fill out each field:
• Name *
  First

  Last
• Street Address *
• City *
• Zip Code *
• Email Address *
• Phone *
• What are the goals you have for your dog? (Check all that apply) *
  Weight loss Conditioning improvement Injury rehabilitation Senior dog mobility Confidence building Anxiety reduction Reactivity or aggression issues Socialization General fitness Enrichment
• How often do you plan to exercise your dog? *
  1 to 2 times weekly (recommended) Every other week Unsure
• What kind of sessions are you seeking?
  Regular and consistent routine Occasional sessions to tire out my dog
• Desired session days (check all that apply)
  Monday Tuesday Wednesday Thursday Friday Saturday
• Desired session time *
  Morning (7AM-10AM) Afternoon (11AM-4PM) Evening (5PM-7PM)
• Pet #1 Name *
• Has pet #1 had their rabies vaccination? *
  Yes No
• Pet #1 Rabies Expiration Date *
• Pet #1 Sex *
  Choose Male Female
• Pet #1 Weight *
• Pet #1 Breed *
• Pet #1 Birthday *
  Approximate if unknown
• Pet #1 Picture
  Select Image
• Pet #2 Name
• Has pet #2 had their rabies vaccination?
  Yes No
• Pet #2 Rabies Expiration Date
• Pet #2 Sex
  Choose Male Female
• Pet #2 Weight
• Pet #2 Breed
• Pet #2 Birthday
  Approximate if unknown
• Pet #2 Picture
  Select Image
• Pet #3 Name
• Has pet #3 had their rabies vaccination?
  Yes No
• Pet #3 Rabies Expiration Date
• Pet #3 Sex
  Choose Male Female
• Pet #3 Weight
• Pet #3 Breed
• Pet #3 Birthday
  Approximate if unknown
• Pet #3 Picture
  Select Image
• Pet #4 Name
• Has pet #4 had their rabies vaccination?
  Yes No
• Pet #4 Rabies Expiration Date
• Pet #4 Sex
  Choose Male Female
• Pet #4 Weight
• Pet #4 Breed
• Pet #4 Birthday
  Approximate if unknown
• Pet #4 Picture
  Select Image
• Vet Clinic *
• Vet Clinic Phone Number *
• Does your dog have any health restrictions? If so, please list: *
  Yes No
• List Injuries Or Restrictions
• Has your dog ever shown aggressive behaviors toward other dogs or people?: *
  Yes No
• Does your dog need to be muzzled? *
  Yes No
• Does your dog have any allergies to treats? *
  Yes No
• Do you consent to your dog receiving treats during his/her training session?: *
  Yes No
• Do you consent to your dog receiving water during his/her training sessions? *
  Yes No
• Has your dog ever used a treadmill before? *
  Yes No

• WAIVER AND RELEASE OF LIABILITY

  I, the undersigned, a customer of RUN DAWG (the “Company”), understand the inherent risks involved in the work performed on my dog by the Company, and all activities relating thereto. Accordingly, and as lawful consideration for the services provided by the Company and for other good and valuable consideration, I hereby certify and agree as follows: Please read and check each box:
• I certify that my dog has been evaluated and deemed suitable for walking/running on a treadmill, and is in good health, current on all required vaccinations (DHLPP, Rabies and Bordetella), taking any necessary Flea/Tick Preventative Medication and has not been ill with any known contagious viruses in the last 30 days. *
  Yes
• I acknowledge that while my dog is fully vaccinated, vaccines are not completely effective in preventing exposure to a contagious virus or disease. I agree that should my dog become ill, such illness is not the responsibility of the Company and that I alone am responsible for my dog’s care. *
  Yes
• By checking this box, I hereby approve that my dog(s) be videotaped, photographed and/or recorded. Run Dawg shall be the exclusive owner to the results and all proceeds of such media and may post on Run Dawg social media platforms. *
  Yes
• I acknowledge that the Company will assess a fee of $25 for appointments canceled less than 48 hours prior to time scheduled, and will charge the rate of one (1) full appointment if canceled less than 24 hours prior to scheduled time. I understand that the Company reserves the right to refuse to schedule future appointments for clients with repeated cancelations or until payment for services rendered or cancelation fees has cleared. *
  Yes
• I AM AWARE & UNDERSTAND THAT THE SERVICES OF THE COMPANY MAY INVOLVE RISKS, DANGERS & HAZARDS, INCLUDING BUT NOT LIMITED TO THE RISK OF SERIOUS INJURY OR PROPERTY DAMAGE. I ACKNOWLEDGE THAT IF MY DOG PARTICIPATES IN THE SERVICES PROVIDED BY THE COMPANY, I ACCEPT & FULLY ASSUME ANY & ALL RISKS, DANGERS & HAZARDS INVOLVED & THE POSSIBILITY OF INJURY OR PROPERTY DAMAGE, WHETHER CAUSED BY NEGLIGENCE OF THE COMPANY OR OTHERWISE. I hereby expressly waive and release any and all claims which I have or may in future have, against the Company, and its officers, directors, employees, agents, representatives, affiliates, shareholders, successors, and assigns (collectively, "Releasees"), on account of injury, illness, disability, death, or property damage arising out of or attributable in any way to the Company’s services, whether arising out of the negligence of the Company or any other Releasee or my dog’s behavior, including without limitation, breach of contract, or breach of any statutory or other duty of care. I covenant not to make or bring any such claim against the Company or any other Releasee, and forever release and discharge the Company and all other Releasees from liability under such claims. I shall defend, indemnify, and hold harmless the Company and all other Releasees against any and all losses, damages, liabilities, deficiencies, claims, actions, judgments, settlements, interest, awards, penalties, fines, costs, or expenses of whatever kind, including reasonable legal fees, fees, and the costs of enforcing any right to indemnification under this Waiver and Release, and the cost of pursuing any insurance providers, arising out or resulting from any claim related in any way to the Company’s services or to my dog’s behavior. This Waiver and Release constitutes the entire agreement between the Company and me with respect to the subject matter contained herein and supersedes all prior and contemporaneous understandings, agreements, representations and warranties, both written and oral, with respect to such subject matter. This Waiver and Release is binding on and shall ensure to the benefit of me and my heirs, next-of-kin, executors and administrators, and the Company and its successors and assigns. This Waiver and Release shall be governed by and construed in accordance with the laws of the state of Nevada and city of Las Vegas. *
  Yes
• Date
• Signature *
  Type legal name into box above to serve as signature
•