Obedience Class Registration Form PAGE 1 - you must print out both pages - Go to Page 2 here

Owner's Last Name:
First Name:
Names any other handlers for classes:
Class You are Registering for (circle one):
Puppy Basics / Training Basics / Beyond Training Basics
Street Address:
City:
State:
Zip:
Email:
Daytime Phone:
Evening Phone:

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Name of Emergency Contact:
Evening Phone:

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Dog's Name:
Breed (and any known mixes):

Age:
Male / Female
Intact / Spayed / Neutered

Please answer the following questions:

Has your dog ever shown any aggression toward a human? ( Yes / No ) If yes, please describe:



Has your dog ever shown any aggression toward another dog? ( Yes / No ) If yes, please describe:





What do you hope to achieve with this class?





Have you ever attended obedience classes before? ( Yes / No )

If yes, where?__________________________________________________________________________________

If yes, did you complete the classes? ( Yes / No ) If no, why not?