Team Training Registration Forms

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New Horizons Logo

All information provided is strictly confidential and for NHSDI use only:

To be completed BEFORE Team Training begins by applicant or parent/guardian of applicant of applicant is a minor. 

In the event you are ill or injured New Horizons Service Dogs, Inc. would like to ensure that your dog is provided for during an emergency. Your dog has a microchip implant that is registered to NHSDI. In the event that the dog is taken to an Animal Control facility, NHSDI will be contacted. We would like to have to following information in order to expedite the release of the dog to the responsible party of your choice. We also request that you keep this information updated with NHSDI at all times. 
Applicant Contact Information







If so, or the ward of the court, the parent or legally authorized representative need to approve and sign this application, pursuant to state or federal laws.
Parent/Guardian Contact








Emergency Contact 1
Please, write here the contact of a relative or closest family member NOT living in the same household.








Emergency Contact 2
Please, write here the contact  of  someone you have known for ten or more years.








Client Policies
1. Clients of New Horizons Service Dogs, Inc. (NHSDI) understand that they are responsible for all of their transportation including to and from field trips during Team Training. 

 2. The client is required to attend all classes, lectures and field trips. Absences beyond one day may result in transfer of the student to another class, or require make-up time. The NHSDI training course lasts thirteen days; however, alternative time periods may be scheduled for those individuals who have unique or additional training needs 

 3. Clients of NHSDI agree to complete the Team Training to the best of their ability and to comply with the requests of the NHSDI Training Staff. If a client does not complete the training, the client will not receive a service dog from NHSDI at that training period. However, the client may be deemed eligible for additional training to provide the client with an opportunity to comply with the training curriculum and receive a NHSDI service dog at a later time. 

 4. Participation in Team Training is not a guarantee that a client will receive a service dog from NHSDI. NHSDI reserves the right not to graduate a team, if the team is not safe in public or if the team has not bonded or learned the proper commands. All clients must show proof of bonding, caring and giving the commands before graduation. If discrepancies cannot be corrected, NHSDI reserves the right to decline you for further training and will invite you to seek other service dog placement opportunities with a different provider. 

 5. When possible, clients are asked to help raise funds for NHSDI or to otherwise voluntarily finance a portion of the cost of their dog. 

 6. Ownership of the dog does not transfer to the client until they have complied with all follow-up procedures, including passing the public access tests. 

 7. In the event that your service dog must be retired for medical or other reasons, you will be given priority over other applicants to receive a new service dog. Replacing your service dog quickly will minimize the impact and down time of living without the assistance that your canine partner provides and that you will come to depend on. 

 8. Each client must be prepared to meet his/her own financial needs during training including field trip costs and unique equipment needs or modifications. Those commuting from surrounding areas may also desire local accommodations on evenings with late night activities. 

 9. Family members, friends, attendants, and others will not be allowed to attend training sessions without prior authorization from NHSDI. Individual needs for child care, health care, note takers, or interpreters must be arranged prior to training. 

 10. After graduation, clients will be required to provide ongoing information regarding their dog’s working habits and medical status. Any dog user who, at any time during training or after graduation, fails to handle a canine placement according to NHSDI requirements, or who handles their dog in an abusive or negligent way, may be deemed ineligible for further participation in this program. NHSDI will require an immediate recall of the dog. The dog will be released to NHSDI personnel upon notification of recall with all equipment issued at the time of placement. If the equipment is unavailable at the location, it will be forwarded to NHSDI within 24 hours of recall. 

 11. New Horizons Service Dogs, Inc. Logo items are only to be used by New Horizons Service Dogs, Inc. Graduate Teams and Trainers. Remember while using logo equipment, you are representing NHSDI. Please do so in a socially acceptable manner. If at any time you are not in compliance with NHSDI follow-up policies and procedures or are found to be representing NHSDI in an inappropriate manner, the logo items will be returned to NHSDI within 24 hours of the surrender request. 

 12. It is NHSDI’s goal to provide the finest level of quality and service to our clients at all stages of training. If at any time questions or concerns arise, whether prior to beginning training or years after placement, please contact NHSDI by phone or e-mail for assistance. Any training or behavior concerns must be communicated to New Horizons immediately upon onset. NHSDI will work with the client team to assess and provide training support. 


 13. All information provided to NHSDI will be strictly confidential. The information will only be used to provide better service to the client (for example, discussing your case with your doctor to obtain more information regarding your disability). 

 14. The client is responsible for all costs involved with the canine placed with them before and after the transfer of ownership. These costs include, but are not limited to: veterinarian care, medication, food, retrieve items, bedding. 

 15. In the event the terms of this contract must be enforced by legal means the prevailing party shall be entitled to recover its attorney’s fees and costs from the non-prevailing party. 

 I have read the above policies and procedures and do hereby agree to abide by them. 

If the above is a minor, signature of parent or guardian.

I, the undersigned, hereby consent to the foregoing conditions and warrant that I have the authority to grant such consent.

Conduct of Applicants and Graduates
Applicants and graduates are expected to act appropriately toward one another and the NHSDI staff. Inappropriate and/or abusive behavior will not be tolerated. If at any time an applicant or graduate feels they are being harassed, abused, treated inappropriately or unfairly, they should bring it to the attention of the Executive Director immediately for investigation and action. This could include legal action against an individual. 

No applicant or graduate will bring illegal substances onto NHSDI property, Team Training location, or field trip locations, nor use illegal substances while in training with NHSDI. 

 At no time should an applicant or graduate become intoxicated to an unacceptable level while in training. It should always be remembered that in public, you are representing NHSDI and should do so in an acceptable manner. 

 No applicant will bring firearms onto NHSDI property, Team Training location, or field trip locations. 

 At no time whether during training or after graduation will abuse of a service dog be tolerated. Allegations of abuse will be investigated by NHSDI and the local animal control for the area. If the allegation has merit, the dog will be removed from service immediately without regard to length of time the dog has been with the client. 

 A NHSDI service dog must always wear a NHSDI cape. 

 If it is deemed the team is not operating in a safe manner, public access through NHSDI will be revoked. The team will need to correct the problems through follow-up training with NHSDI and pass another ADI public access test.

If the above is a minor, signature of parent or guardian.

I, the undersigned, hereby consent to the foregoing conditions and warrant that I have the authority to grant such consent.

Filing a Complaint
In the course of training and/or participating in any NHSDI programs whether as a client, volunteer or employee, you feel that circumstances require correction, the process for filing a complaint is as follows (please note that all complaints will be thoroughly investigated and if deemed appropriate, actions taken): 

Remember that during any differences between parties, a resolution between those parties should first be attempted. If a resolution cannot be met or the matter involves any form of harassment, a complaint should be filed. 

 If the complaint involves a person in this chain, then the person above that individual will be the start of the complaint. 

Complaints regarding minor problems should be done verbally. Complaints regarding harassment should be done first verbally and a written statement should be made regarding the incident. 

 Complaints regarding major problems should be made verbally and in a written statement to the Executive Director, Janet Severt. 

 New Horizons Service Dogs, Inc. is a member of Assistance Dogs International and follows the standard and ethics prescribed therein. A copy of the ADI standards and ethics will be made available upon request.

If the above is a minor, signature of parent or guardian.

I, the undersigned, hereby consent to the foregoing conditions and warrant that I have the authority to grant such consent.

Client Follow-Up Procedures
All team training graduates and individuals that have completed team training must complete the follow-up procedure that follows.

1. The dog will be seen by the client’s veterinarian at their home location so that the dog is an established patient with that office. This visit must occur, or at a minimum be scheduled, within two (2) weeks of the completion of team training. A copy of all Veterinarians’ reports will be sent to NHSDI as soon as they are obtained. Clients are required to abide by the health and maintenance guidelines explained during team training and according to state and local vaccination protocol. The client is responsible for all costs involved with the NHSDI canine placed with them including, but not limited to, costs for veterinarian care and any medication. 

 2. The client will provide a progress report in writing by e-mail or standard mail every month for the first six (6) months after completion of team training. This report will include: the dog’s health status, the dog’s weight, any command problems that might be occurring, how well the dog is performing in public and/or if any problems have occurred in public. If the client is physically unable to provide this report in writing, other arrangements must be made prior to the due date of the first report. 

 3. Any client that has not passed the public access test, but has completed team training, must schedule a subsequent public access test within one (1) month of completion of team training. The second public access test must occur within two months of completion of team training. 

 4. All graduates of team training must complete the following every year to maintain public access through NHSDI.
a) Electronic Annual Report
b) In-Person Follow Up (Public Access Test) as scheduled by NHSDI
c) Submit annual veterinary report (showing updated vaccine and health records) at time of annual reports (this is in addition to submitting a report from your first vet visit)

 5. A return visit to the NHSDI facility will be scheduled, by the client, within one (1) months and three (3) months of completion of team training as a post training follow-up. 

 6. New Horizons Service Dogs, Inc. follows the Standards and Ethics of Assistance Dogs International and each NHSDI client will be required to follow same as part of the NHSDI program.

If the above is a minor, signature of parent or guardian.

I, the undersigned, hereby consent to the foregoing conditions and warrant that I have the authority to grant such consent.

Consent to Contact
Type your name
I recognize a New Horizons Service Dog is frequently asked to put on presentations for individuals and groups who would like more information on this program. As a recipient of an service dog, I understand that I may be asked to participate in this type of program.

I understand that if I am contacted, I am under no obligation to appear on behalf of New Horizons Service Dogs, Inc. 

If the above is a minor, signature of parent or guardian.

I, the undersigned, hereby consent to the foregoing conditions and warrant that I have the authority to grant such consent.

Liability Form Waiver and Release & Non-Disparagement Agreement
Type your name
I indemnify and hold harmless from and against all claims, losses, liabilities, and damage to persons or property, governmental charges or fines and attorneys’ fees arising out of the acts or omissions of New Horizons Service Dogs, Inc. Training Seminar, Training Class, meetings, or any gathering sponsored by or conducted at New Horizons Service Dogs, Inc. offices, including but not limited to interactions with instructors, attendees, or animals.

I am knowingly and willing executing this agreement to certify that if anything whatsoever that happens relating to the dog, its training or my training with the dog, no matter who is at fault, I will not pursue any claims for personal injuries or property damages against New Horizons Service Dogs, Inc., its officers, agents or employees.

By signing this agreement below, I understand and agree to the entire agreement. If any person, including me, is injured, or any property, including mine, is damaged, I will not pursue a claim against New Horizons Service Dogs, Inc., its officers, agents or employees for any personal injuries or property damage relating to the dog, its training, or my training with the dog, and any claims or judgments connected thereto shall be my sole responsibility.

I agree now and hereafter not to disparage or defame New Horizons Service Dogs, Inc. in any respect or to make any derogatory comments, whether written or oral, regarding New Horizons Service Dogs, Inc. or its current or former officers, directors, employees, agents or contracting parties, or its business or operations. The sole exception is that recipient may make truthful statements about New Horizons Service Dogs, Inc. and/or its current or former officers, directors, employees, agents or contracting parties, or its business or operations, only if compelled by Court Order, legal proceeding or otherwise required by law, without violating the aforesaid non-disparagement requirements. If recipient defames or disparages New Horizons Services Dogs, Inc. or its current or former officers, directors, employees, agents or contracting parties, or its business or operations, then recipient shall be liable for all reasonable expenses incurred by New Horizons Service Dogs, Inc., including attorneys' fees and costs, in the enforcement of obligations created by this clause.

If the above is a minor, signature of parent or guardian.

I, the undersigned, hereby consent to the foregoing conditions and warrant that I have the authority to grant such consent.

Media Authorization and Release
Subject to the terms and conditions set forth herein this agreement, I,
Type your name
do hereby irrevocably authorize New Horizons Service Dogs, Inc. and/or Janet Severt, its successors and assigns and those acting under its permission and on its authority to copyright, use, and publish, for art, sales materials, advertising, promotion, packaging, trade, or any other lawful purpose whatsoever, articles written or comments made by me (whether utilized in my name or a fictitious name) as well as any and all photographs, pictures, portraits or images or reproductions thereof, in color or otherwise made through any medium, of me and/or my dog(s) or other animals(s). Any and all comments made by me are provided to Janet Severt without receipt of any promise of consideration.

The undersigned warrants he/she has the full power and authority to grant all of the rights conveyed hereunder and hereby waives any right that he/she may to inspect or approve the finished product or the advertising or other copy that may be used in connection therewith or the use to which it may be applied. The undersigned further agrees that this authorization and release shall be binding upon his/her heirs, executors, administrators, successors and assigns.

The undersigned warrants that all comments made by me will accurately reflect the opinions and experience of the undersigned and that the comments are true and correct to the best of the undersigned’s knowledge and belief.

The undersigned further warrants that he/she is of full age and has every right to contract in his/her own name in the above regard and, further, that he/she read the above authorizations and release prior to its execution, and that he/she is willingly and voluntarily executing same with full knowledge of the contents thereof.

If the above is a minor, signature of parent or guardian.

I, the undersigned, hereby consent to the foregoing conditions and warrant that I have the authority to grant such consent.

Medical History
The information you provide in this medical history is obtained for the sole purpose of providing the best service to the client and to provide for emergencies. The information will not be released to anyone or used for any other purpose without express consent of the client. NHSDI will hold this information confidential and secure.






If the above is a minor, signature of parent or guardian.

I, the undersigned, hereby consent to the foregoing conditions and warrant that I have the authority to grant such consent.

Consent for Emergency Medical Treatment
Type your name


If the above is a minor, signature of parent or guardian.

I, the undersigned, hereby consent to the foregoing conditions and warrant that I have the authority to grant such consent.

On-Site Safety Program
In the event of an emergency, all clients and volunteers will respond to staff direction and implement those instructions immediately and in an orderly fashion. Our number one goal is to promote safety for clients, staff and dogs. Please let us know immediately if you have a chronic condition that may become exacerbated during the training so that we can accommodate any special needs, i.e., seizure disorder, allergies, etc.

Call 911 immediately in the event of an emergency.

 1. Designated evacuation sites will be shown during team training. The actual site that you will go to will depend on the nature of the emergency and the location/source from which it is coming.

2. Once at the evacuation site, staff will conduct a head count to determine if everyone is present and accounted for.

3. Fire extinguisher locations and First Aid kit locations are indicated on the evacuation chart. Please take the time to familiarize yourself and “visit” both locations.

4. Fire drills will be conducted during Team Training in order to simulate an emergency. This will involve moving people, wheelchairs and dogs, so that, in the event of an emergency, you will know how to proceed.

5. Should you be required to provide first aid care, please use the protective devices that are provided in each First Aid Kit. There are gloves, hand sanitizer, and a CPR tube in each kit.

 6. Florida is a “right to know” state. Prior to using any product, please check the contents to make sure it does not contain any chemicals that you might have sensitivity or allergies to. Never, ever combine two or more chemicals.

7. Should you splash chemicals in to your eyes, there is eye-wash solution in the First Aid kit.

I hereby acknowledge the receipt of this information and agree to comply with all of the safety requirements outlined above.

If the above is a minor, signature of parent or guardian.

I, the undersigned, hereby consent to the foregoing conditions and warrant that I have the authority to grant such consent.

Sworn Statement
I hereby certify that, to the best of my knowledge and belief, I have answered all the questions accurately and honestly and that all the informations supplied in this application is correct.
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