Registration Form
Instructions: Please complete and select AGREE & SUBMIT at bottom. Upon submission, we will email you with payment instructions. Once we've received payment, you will receive an email confirmation and vital Orientation information.
 
Which Seminar/Class?
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Owner First & Last Name
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Street Address (please note if mailing is different)
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City, State, Zip
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Home Phone
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Cell Phone
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Email
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How Did you Find Us?
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Dog's Name
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Dog D/O/B
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Breed
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Is dog Spayed or Neutered?
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Vet's Name & Phone
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Is dog current on shots?
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What are your training goals?
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Do you compete? If so, which sport, what class, how long?
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What Problems are you having?
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Do you feel your dog Stresses up or down in competition? Elaborate, please
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Have you taken previous training classes? Describe
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WAIVER
I hereby acknowledge I have voluntarily applied for dog owner/handler training, fitness, or related services, conducted by Canine Culture, LLC & Laura Bussing. I fully understand that such training and services pose numerous risks to the health and safety to myself and my dog. I freely and knowingly assume these risks, which include, but are not limited to, the following representative examples, which are not intended to be all-inclusive: the risks of the owner/handler being bitten, scratched, soiled, tripped, yanked, jerked, attacked, frightened, or otherwise injured by other dogs in the classes, or by the owner/handler's own dog; the risks of tripping over or slipping upon floor matting, dogs, or dog-training related objects, or slipping on dog drool or dog solid or liquid waste matter, or colliding with dogs, other human participants, dog training props, dog jumps, dog obstacles, dog gating or building parts, including but not limited to, walls, doors, and support beams. I do not hold Canine Culture, LLC, its members, officers, agents, trainers, and employees or Laura Bussing responsible for any damages, injuries, or liabilities caused by my animal. Also, I will not hold Canine Culture, LLC, its members, officers, agents and employees or Laura Bussing legally or financially responsible for any injury to my dog or myself. I understand that I am responsible for my dog and its actions, and understand that the Colorado Dog Bite Law holds me responsible to pay compensation for any injuries sustained to any person other than the trainer. I give Canine Culture, LLC & Laura Bussing my permission to use any photos or videos of myself & my dog for marketing and/or training purposes.
REFUNDS: For Evaluations & Privates, Refunds are given only in case of medical or other emergency. For Seminars, refunds are given only if your working spot can be filled. And auditing spots are refunded if 24 hr notice is given.
GUARANTEE: I acknowledge there are NO guarantees when training dogs. It is unethical for Laura Bussing to make any guarantees as a Certified Professional Dog Trainer.
 
 
 
 
YOUR EXPERIENCED CANINE EDUCATOR
CANINE CULTURE, LLC
Laura Bussing