Register: Walking With Your Dog

Guardian’s Name
Daytime Phone
Evening Phone
Street Address
City, State, Zip
email
Dog’s Name
Breed(s)
Age
Sex	Male Neuter Female Spay Male Intact Female Intact
Emergency Contact
Emergency Phone
Alternate Emergency Phone
Vet Office/Name of Veterinarian
Veterinarian Phone
Dog’s Recent Vaccination & Health History
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:
Have you done any previous training with this dog? If so, what was the basic approach?
Describe what your dog does when she sees an unfamiliar person:
Describe what your dog does when she sees an unfamiliar dog:
What style of heeling would you like to work on in this class?	Let’s Go! Polite walking for the family dog Foundation Rally Intermediate Rally Competition Obedience Canine Freestyle HTM/Heelwork to Music Other performance sport/specify below
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