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Adolescent Puppy Class Registration Form

"*" indicates required fields

Class/Clinic Start Date*
MM slash DD slash YYYY

Handler's Name*
First Last

Dog's Name*

Dog's Breed Type*

Dog's Age*

Dog's Gender*

Male

Female
Handler's Address*
Street Address Address Line 2 City State ZIP Code

Home Phone
Cell Phone
Work Phone
Handler's Email*
Enter Email Confirm Email

Vet's Name*

Spayed or Neutered?*

Yes

No
Does your dog have physical limitations?*

Yes

No
If yes, please explain:
List other pet family members:
List other human family members of the household along with their respective ages:
Dog acquired from:*

Pet shop

Breeder

Shelter

Other

Age of dog when acquired*

How long have you had this dog?*

Where does the dog sleep (be specific)?*
Do you use a crate?*

Yes

No
How many hours is your dog left alone each day?*

How is your dog confined when outdoors?*

What activities do you do with your dog?*
What tricks does your dog already know?*
Have you attended training classes before?*

Yes

No
If yes, when & where?

What do you want to accomplish in this class?*
What is your dog's regular food?*

What are your dog's regular treats?*

What time(s) are your dog's meal(s)?*

Select all that apply to your dog (CTL+CLICK to select multiple):
Briefly explain anything you selected above:

Δ

Please provide a copy of your dog’s shot records and sign and return the liability form (you may need to download Adobe Reader if you don’t already have it). You will not be enrolled into the class/clinic until you have. No exceptions will be made.

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