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

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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:

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

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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?

Method of Payment

Pay Online   Bring Check to Class