| Guardian’s Name |
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| Daytime Phone |
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| Evening Phone |
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| Street Address |
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| City, State, Zip |
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| email |
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| Dog’s Name |
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| Breed(s) |
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| Age |
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| Sex |
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| Emergency Contact |
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| Emergency Phone |
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| Alternate Emergency Phone |
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| Vet Office/Name of Veterinarian |
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| Veterinarian Phone |
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| Dog’s Recent Vaccination & Health History |
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| Dog’s Dietary or Medical Restrictions, etc |
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I have read the
Liability Waiver & Policies (here) |
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I have read & agree to abide by
the Center Guidelines (here) |
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May we use photographs of
you & your dog on our website? |
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May we update your veterinarian
regarding your training progress? |
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Does your dog have any medical or behavioral issues
you think we should know about? Explain: |
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Have you done any previous training with this dog?
If so, what was the basic approach? |
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Describe what your dog does
when she sees an unfamiliar person: |
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Describe what your dog does
when she sees an unfamiliar dog: |
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What are your most important goals
for your dog in this class? |
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| What would you most like to learn in this class? |
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What else would you like us to
know about you and your dog? |
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| How did you hear about us? |
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| Method of Payment |
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| Which class do you plan to attend? |
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| |
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