Therapy Visit Registration

	All Heart Dogs NT Therapy dogs have been assessed and found suitable for therapy work, there may be circumstance or situations that the dogs are not fully socialised for, in the event that a dog is the wrong fit for any situation another dog will be offered to ensure that the needs of the individual are met.
How did you hear about us? * Website\|Petrescue\|Facebook\|Instagram\|Radio\|WordofMouth\|Other
Owner First Name *
Owner Surname *
Phone Number *
Email Address (non NT Gov or NT Schools email addresses please)(Please check spam folder as you will get an automatic email once you submit this form and future emails may also go there) *
Facebook Profile
What type of dog would you like a visit from?
*	Our dogs are up to date with vaccinations and worming
SERVICES PROVIDED: Sessions are provided by Lisa Hansen Dip AAT, a professional dog trainer, and the PAWS darwin team.
First session will be $140 unless otherwise discussed. *
REMOVAL FROM SESSION: Trainer, at his/her sole discretion, may remove a pet from session if a hazard or threat of any nature to any animal or person is present. No refund will be given under such circumstances. Unless sit is the handler at fault *
	CLEANLINESS: While our dogs are toilet trained and clean, it is possible that accidents can occur, the handler will be responsible for ensuring that the animal has access to toilet and water and any other needs the animal may have during its session time. Even if this means there is some disruption to the session.
LIABILITY: The Session User (Owner) agrees to indemnify and hold Heart Dogs NT Handlers, employees/agents harmless from all liability for any loss, damage or injury to persons, animals or property arising from or related to handlers pet. *
Owner agrees that Handler shall not be liable for loss or damage to persons or home for any reason unless said loss or damage was a direct result of Handler’s negligence. *
Signature of Applicant. Please use your finger on touch screen or click and hold your left button to use your mouse above the line. * Please sign on screen or click and hold your left button to use your mouse.
Date *