Kip Homestead Training Enrolment Form "*" indicates required fields 1About You2About Your Dog3More Info Do you authorise Kip Homestead Yarra Valley to take your dog away from premises to re-enforce the training process?*IMPORTANT – There may be a specific need in the training process to take your dog to a highly populated area to work with high levels of distraction to cement the training process (e.g; a local shopping centre, train stations, Lillydale Lake etc.) We require your authority (if you choose) to further your dog’s training outside of Kip Homestead Yarra Valley facility. Yes No About You* First Last Email* Phone*Address* Street Address City State Postcode Preferred Method of Contact* Phone Email Emergency Contact Details* Name Phone Number*By completing this form, you agree for Kip Homestead Yarra Valley to enrol your dog in our Exclusive Board & Train Program.* I agree Would you like your dog booked in for the next available training date?* Yes No I have specific dates I would like (Please add your preferred dates in the Additional Notes Section towards the end of the form) About Your Dog* Name Breed Name* D.O.B Colour Is your dog desexed?* Yes No Gender* Male Female Current Vet Clinic Name & Phone Number* Please list the words you currently use for your dog's commands (Sit, Drop, Recall etc).*Please number in order of priority (with 1 being the most important to you) the following commands for your dog to learn.*Has your dog had any prior formal training?* Yes No What prior training/learning has your dog had and where? (Name of Trainer, Puppy School, Obedience Club etc).*What training methods/equipment did the previous trainer use for your dog?*Have you done any kind of training with your dog previously?*Does your dog visit dog parks? From what age did they start?*Has your dog ever bitten another dog, been bitten by another dog, or bitten a person? If so, provide details: When did this happen? Severity? Broken Skin? Hospitalisation? Vet Involvement? Council Involvement? At what age did this occur? (Note: If a dog has started biting over the age of 4, there may be a medical condition involved and therefore, we would recommend a thorough vet examination to check things like eyes, joints etc to rule out an underlying illness or conditions).*Does your dog ever react with barking, anxiety, lunging, or aggressive behaviour towards other people?*Does your dog ever react with barking, anxiety, lunging, or aggressive behaviour towards other dogs? If so, what type (large/small/specific breeds)?*Does your dog ever react with barking, anxiety, lunging, or aggressive behaviour towards anything else (sounds, vehicles, bikes etc)? If so, when did you first begin to notice this behaviour?*What is your dog most motivated by (food, pats, toys etc)? What is their favourite treat?*What is your dog currently eating at home?*Does your dog have any allergies (grass, food etc)? Please list.*Is your dog on any medications or does your dog have any medical issues? Please list.*What is your desired end result from your dog's training stay at Kip Homestead? (Walk past another dog without reacting etc.)*Any Additional Notes/Comments?