Registration Form - Advances In Animal Behavior- Welcome by gabyion

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									     Registration Form for Agility and Dabble in Dog Sports Classes
Class Details: In these classes, dogs will be off leash at times and running over equipment
                       We cannot guarantee your safety or your dog’s safety.
                       You are responsible for your dog’s behavior and any injuries that they or you
                          may incur while training
                       Only your instructor may break up a dog fight. We will supervise and remove
                          dogs that we deem unfit for class
                       Dogs should not be off leash without instructor permission
OWNER’S NAME
(18 OR OLDER)_______________________________________________

HOME PHONE_____________ WORK PHONE_______________ E-MAIL_____________________

ADDRESS_________________________ CITY________________ STATE____ ZIP_______

DOG’S NAME___________________BREED_________________ AGE____ DOG’S SEX_____

I, (PRINT NAME)________________________________________WISH TO ENROLL MY DOG IN

(PLEASE CIRCLE) OBEDIENCE/AGILITY FOR KIDS OR ADULTS
                INTRODUCTION TO AGILITY I OR II
                STARTERS AGILITY
                DABBLE IN DOG SPORTS

UNDER THE DIRECTION OF ADVANCES IN ANIMAL BEHAVIOR/KRISTEN PHILLIPS. AS LEGAL OWNER OF
MY DOG, HAVING CAREFULLY READ AND UNDERSTOOD THIS AGREEMENT, I DO HEREBY WAIVE AND
RELEASE ADVANCES IN ANIMAL BEHAVIOR, KRISTEN PHILLIPS, PAWSITIVELY HEAVEN PET RESORT INC,
FROM ANY AND ALL LIABILITY OF ANY NATURE. THIS INCLUDES ANY INJURY, DEATH, SICKNESS OR
DAMAGE MY PET MAY SUFFER DURING OR AFTER ANY TRAINING SESSION. I ALSO AGREE TO
INDEMNIFY AND HOLD HARMLESS ADVANCES IN ANIMAL BEHAVIOR, KRISTEN PHILLIPS, AND
PAWSITIVELY HEAVEN PET RESORT INC, FROM ANY AND ALL CLAIMS DUE TO ANY DAMAGE MY PET
MAY CAUSE TO ANY FAMILY MEMBERS OR ANY THIRD PARTIES DURING OR AFTER TRAINING. I
UNDERSTAND THAT I AM RESPONSIBLE FOR MY DOG’S BEHAVIOR.

I HAVE READ, UNDERSTAND, AND AGREE TO ALL TERMS AND CONDITIONS SET FORTH ABOVE. ENROLL
ME!

SIGNATURE________________________________________________________________

$130.00 for 7 one hour sessions
Make Checks or Money Order payable to: “Advances in Animal Behavior” and send to:
Advances in Animal Behavior 8800 W. 85th Place, Justice, IL 60458

Questions: Call Kristen 630-258-2600
Your Name ____________________________________Dog’s Name__________________



Due to the variability in canine temperaments, sizes, and levels of training we ask
that you allow us to assign you into a class that best suits your dog. Please list
up to 3 classes and times that you would like to participate in.


1st Choice:
Name of Class: ________________________Day of Week_____________ Time________


2nd Choice
Name Of Class ________________________Day of Week _____________Time________
   Check here if you have no second choice


3rd Choice
Name of Class _________________________Day of Week _____________Time________
   Check here if you have no third choice



Please tell us about your dog; Please feel free to ad lib. You don’t need to
answer every single question. But please give us enough information to give us
a good description of your dog.

1. How big is your dog? Weight? Approximate height from floor to top of shoulder blades?
How old is your dog? Breed? Spayed/Neutered? Any Health Problems?
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2. Tell us about your dog’s obedience training. Has your dog been to any group classes?
When? What kind (i.e, puppy-kindergarten, basic training…)? Where? Did your dog finish the
class? Can your dog focus on you when it is around other dogs/people/outside?
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Your Name ___________________________________Dog’s Name____________________

3. Tell us about your dog’s sports experience. Has your dog been to any sports classes?
When? Where? What kind? If your dog has agility experience, tell us about the heights of the
equipment. Was your dog running a full height A-Frame, Teeter, Dog Walk?… If not full
height, then what heights? Weave poles straight up or open?
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4. Tell us about your dog’s personality and socialization history. Does your dog shy away
from people/other dogs? Does your dog bark/lunge at other dogs when on leash? Does your
dog seem to worry about strange noises? Do you have a lot of company? Or do you take your
dog off of your property to socialize with other dogs and people? Does your dog play nicely off
leash with other dogs? Does your dog bite your hand when you grab it by the collar?
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5. Tell us about your training goals? Why are you taking this class? Do you want to train your
dog to competition level? Do you plan to practice outside of class?
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6. Tell us your veterinarian’s name, address, and phone number.
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Thank you for taking the time to fill out this form so that you and your dog can have an
enjoyable class experience. We will notify you via e-mail or telephone to let you know which
class you got into and what you need to bring to class We highly recommend that you inform
your veterinarian that you’re coming to class and make sure that your dog is up to date on
vaccine requirements. We look forward to meeting you.

								
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