Fillout the form and we Promise To contact you in less than 24 hours. Free 15 minute call "*" indicates required fields Name of the PRIMARY ADULT who will do the training* First Last Email Address of the Primary Person training* Other Details*Phone Number of Primary Person Doing The Training Add RemoveStreet Address Of the Primary person training:* Street Address City State / Province / Region ZIP / Postal Code Days and Times it is easy for you to chat. Tuesday Morning Tuesday Around Noon Wednesday Morning Wednesday Around Noon Wednesday MidAfternoon Thursday Morning Thursday Around Noon Thursday MidAfternoon Thursday Late Afternoon Friday Morning Friday Around Noon Friday MidAfternoon Friday Late Afternoon Saturday Afternoon Pick all that works well for you.Your Dog's Information*Your Dog's NameBirthdateVeterinary Office Add RemoveWhich Most Interests You?* Group Classes Private Training Both Group and Private Training Online Self-Study To Help Me Prepare For Your Free Call, Tell MePick Your Top, Most Pressing Goal* Reactivity, Fear Jumping on People Playful Biting Listening Skills Come Loose Leash Walking Sit, Down, Stay Over Excitability House Training Puppy Training (puppy under 16 weeks) Other You picked Other, tell me your top goalWhat is your most pressing question you would like answered?*What do you dream of doing with your dog that you presently can not?*How much time do you have each day to devote to your training?*When you feed your dog, how long does it take to finish the bowl of food* All the Food is gone in less than 5 minutes All the Food is gone in 5 minutes to 1 minutes Longer Than 15 minutes How does your dog respond to seeing people (both when your dog is on leash and off leash)? (Check all that apply)* Looks at them but stays with you Ignores them whines and pulls towards the dog hackles go up (hair on back of neck/shoulders) Drools / Salivate Paces Freezes Pants More Refuses food or treats Growls Bares their teeth Snaps/Bites/Aggresses High pitched barks and lunges toward the dog Deep toned barks and lunges toward the dog Yawns Tucks their tail Pees or Poops Trembles / Shakes Seeks comfort from you Shy / Cautious Hide / Tries to Escape or moves away How does your dog respond to seeing other dogs (both when your dog is on leash and off leash)? (Check all that apply)* Looks at them but stays with you Ignores them whines and pulls towards the person hackles go up (hair on back of neck/shoulders) Drools / Salivate Paces Freezes Pants More Refuses food or treats Growls Bares their teeth Snaps/Bites/Aggresses High pitched barks and lunges toward the person Deep toned barks and lunges toward the person Yawns Tucks their tail Pees or Poops Trembles / Shakes Seeks comfort from you Shy / Cautious Hide / Tries to Escape or moves away How did you find out about our training?*Agreements, Policies and ConditionsI understand all materials (videos, handouts) shared with me are for my personal use and agree to not share them with others.* Yes I understand The Well-Mannered Dog is an educator who may use my and my dog’s likeness, voice, name, images in any and all audio, written or visual format to be used in educational materials and marketing. I hereby relinquish, give and assign to The Well-Mannered Dog, LLC all rights, title, and interest I may have in the materials without limitation. In addition, I acknowledge The Well-Mannered Dog is the owner of said materials without payment or compensation to me.* Yes Hold Harmless Waiver - Submitting your application, signifies your agree to our Agreement To Hold Harmless, Waiver And Assumption Of Risk waiver. Agreement To Hold Harmless, Waiver And Assumption Of Risk – I understand that attendance of a dog training class is not without risk to myself, members of my family, guests who may attend, or my dog, because some of the dogs to which I will be exposed may be difficult to control and may be the cause of injury even when handled with the greatest amount of care. I hereby waive and release THE WELL-MANNERED DOG, LLC hereinafter referred to as the Training Organization, its employees, officers, members and agents from any and all liability of any nature, for injury or damage which I or my dog may suffer, including specifically, but not without limitation, any injury or damage resulting from the action of any dog, and I expressly assume the risk of such damage or injury while attending any training session, or any other function, of the Training Organization, or while on the training grounds or the surrounding area thereto. In consideration of and as inducement to the acceptance of my application for training membership by this Training Organization, I hereby agree to indemnify and hold harmless this Training Organization, its employees, officers, members and agents from any and all claim, or claims by any member of any family or any other person accompanying me to my training session or function to the Training Organization, or while on the grounds or the surrounding area thereto as a result of any action by any dog, including my own.* I agree CAPTCHA