Register for LRR2: New Challenges

Guardian’s Name
Daytime Phone
Evening Phone
Street Address
City, State, Zip
email
Dog’s Name
Breed
Age
Sex
 Male Neuter 
 Female Spay 
 Male Intact 
 Female Intact 
Emergency Contact
Emergency Contact Phone
Vet Office/Name of Vet
Veterinarian Phone
Dog’s Recent Vaccination & Health History/Current Until
Dog’s Dietary or Medical Restrictions, etc

I have read the Liability Waiver & Policies (here)
 Yes 
I have read & agree to abide by the Center Guidelines (here)
 Yes 
May we use photographs of you & your dog on our website?
 Yes 
May we update your veterinarian regarding your training progress?
 Yes 
Does your dog have any medical or behavioral issues you think we should know about? Explain:

Did your dog complete Leash Reactivity Rehab? If not, have you done any previous training with this dog?

Describe what your dog does when she sees an unfamiliar person:

Describe what your dog does when she sees an unfamiliar dog:

What are your most important goals for your dog in this class?

What would you most like to learn in this class?

What else would you like us to know about you and your dog?

How did you hear about us?
Method of Payment
 Pay Online 
 Bring Check to Class