Group Class Registration Form

Please select your class here Level I Manners ~ Mondays at 7:30pm ~ begins November 22, 2010 Level I Manners ~ Tuesdays at 6:30pm ~ begins October 26, 2010 Level II Manners ~ Tuesdays at 6:30pm ~ begins September 14, 2010 Tricks ~ Tuesdays at 7:30pm ~ begins September 14, 2010 Social Skills ~ Mondays at 7:30pm ~ begins September 27, 2010

Owner's Name
Street Address
City State Zip
Phone Email

Pet's Name Age or Date of Birth
Breed Sex male female Neutered? yes no

Is there anything special we should know about you or your pet?
(e.g. food allergies, shy around strangers, etc)

Has your dog ever bitten another person or dog? no yes

If yes, please describe:

How did you hear about us?

Disclaimer: I understand that pet training is not without risk to me, members of my family or my pet. 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 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 I agree to check my email frequently during the course of this class.

Immunizations: Please bring a copy of your pet's vaccination record to the first class. All pets must be vaccinated for rabies (if old enough). Sorry, no exceptions. I Agree to these Terms and Conditions.

I agree to these terms and conditions.