fbpx
adareg2

Please complete this Registration Form either before or after the purchase of your Group Class or Private Training program!

adareg1

Your Info

Your Name

Your Email

Primary Phone Number

Is that your Home, Work, or Cell?

Backup Phone Number

Address

City, State, and Zip Code

Emergency Contact Name

Emergency Contact Phone Number

Private Training or Group Class Name

Class Start Date (or First Day for On-Going Classes)

Class Start Time

Your Dog's Info

Your Dog's Name

Dog's Breed(s)

Dog's Birthdate or Approximate Age (if age, please specify years, months, weeks)

Dog's Weight

My Dog is a(n):
 Unaltered Male Neutered Male Unaltered Female Spayed Female

Up to Date on Required Vaccinations?
 Yes No

Free of Internal and External Parasites?
 Yes No

Veterinarian's Name

Veterinarian's Phone Number

How did you hear about us and our services?

Name of referring individual, organization, or business:

Has your dog shown signs of aggression towards people or other dogs?
 Yes, towards people Yes, towards other dogs Yes, towards both people and other dogs No, no signs of aggression shown

Behavior problems or anything else we should be aware of?

Photo and Video Release (On our Website, Social Media etc.)

Please answer the question below so we know you're not a robot (or a dog).

I accept All Dogs Allowed Terms (click to view)

After clicking Submit, if you are redirected to the Cart page, the form was submitted successfully and you're all set to continue with your purchase (if you have not done so already).