If you would prefer to print out this form and mail or fax it, please click here for a pdf version.
What is the best way to contact you?*
Please list their names, age and relationship:
Sex, spayed or neutered?*
Vaccinations Current?*
Do you have any food related issues?*
Has your dog ever harmed or shown aggressive or threatening behavior towards any person or dog?*
Has your dog ever bitten another dog?*
IF YES, did your dog break skin?
Has your dog ever bitten a human?*
Is your dog on any medications?*
Other animals in the family:
By submitting this form you agree to the terms and conditions outlined in the Class Participation Agreement.
Would you like to receive our newsletter?*
A copy of your email will be sent to the email address you provided.