Puppy Registration Form

THANKS FOR REGISTERING FOR PUPPY CLASS. YOU WILL HAVE A PRIVATE LESSON FOLLOWED BY 5 GROUP CLASSES. ONCE I HAVE RECEIVED YOUR COMPLETED REGISTRATION, I WILL BE IN TOUCH TO SCHEDULE YOUR PRIVATE LESSON. AFTER THE PRIVATE LESSON I WILL GIVE YOU INFORMATION TO TAKE FOR THE 5 CLASSES.
Your Full Name*
Street address*
City*
State, Zip Code*
Your email address*
The best number to reach you*
Can we text you at this number?	YES NO
Your Dog's Name*
Dog's Date of Birth or Age
Dog's breed(s)
Is your dog spayed or neutered?	NO- male YES - male NO - female YES - female
Has your dog ever bitten a person or dog?	NO YES If YES, please explain below.
Is there anything you would like to tell me about your pet?:	Shy with people, allergies etc
Veterinarian's Name
Veterinarian's phone number
Vaccine Record (Please upload picture or document.)	Please upload your dog's vaccine record.
DISCLAIMER: I understand that pet dog training is not without risk to me, members of my family or my dog. I agree that in the event of injury to my family, my dog(s) or myself, I will hold Kim Yocklin, Canine Character, LLC, and the property owner where the class is held, harmless from any and all liability for any loss, damage or injury to any person, any animal or anything that may have arisen out of or are in any way connected with participation in training classes held by Kim Yocklin and/or her trainers, assistants and representatives. Furthermore, I assume all responsibility for any loss, damage or injury done to myself, property, other persons, or other dogs by my dog's actions or by me. While the Trainer uses best practices accepted by the profession, no guarantee is made of your dog's behavior, now or in the future. I understand that class sizes are limited and that my place in the class will only be reserved for me only when my payment has been received and acknowledged. I understand that all class announcements will be sent by email and/or text and I agree to check both frequently during the course of the class.