Training Registration Form

CLIENT INFORMATION

First name

Last name

Phone

Address

Other family members that may be attending classes:

What service are you interested in for your dog? (check all that apply)

Group Class: 3 Weeks

Group Class: 6 Weeks

Private Lesson

Board & Train

DOG'S INFORMATION

Dog's Name

Approximate Date of Birth

Month

Day

Year

Breed

Veterinarian Name & Phone #

Please note that puppies under 16 weeks of age need their age appropriate vaccinations to enter class. Dogs over 16 weeks of age need all of their vaccinations up to date.

Are your dog's vaccinations current?

Yes

Age Appropriate

Date Rabies Given (if under 16 weeks of age leave blank):

Month

Day

Year

Date Distemper/Parvo (DHPP) Given:

Month

Day

Year

Date Bordetella (Kennel Cough) Given:

Month

Day

Year

Date Canine Influenza Given (optional):

Month

Day

Year

TRAINING INFORMAITON

What are your training goals for your dog?

Any behavioral problems that you want us to address? If yes, please elaborate:

Has your dog shown aggression towards other dogs, people or other animals? If so, please briefly describe what happened:

IN CASE OF EMERGENCY

Emergency Contact Name & Phone #:

Preferred Emergency Veterinarian Name & Phone #

Please look in your email for our replay (also check your spam folder). It is easier to get your dog set up for our classes this way. Also, we ask for at least 1-2 business days for our reply. We appreciate your patience!