Class REGISTRATION Form - NEW STUDENT

Name

First Name

Last Name

Email Address

Cell Phone

(###)

###

####

Last Minute Contact Information

Select the best way for me to contact you if I have to make changes on the day of class

Text

Emergency Contact Information

Who I can call in the event of an emergency

Address

City, State, Zip

Dog's Name/Age/Breed

Where did you get your dog?

How long have you had your dog?

Does your dog have any health concerns or other issues (fears, phobias etc) that you would like us to be aware of?

Are your dogs vaccines up-to-date? Give dates Rabies and DHLPP are due

Please describe your dogs daily activities

Have you done any previous training with your dog. Please give a brief description

Has your dog ever shown aggression towards another dog? If so please describe.

Has your dog ever bitten a person? If so please describe what happened and extent of bite

How did you hear about us?