Dandy Dog Training



Dandy Dog Training

72 Lonesome Rd, Newville, PA 17241

717-776-7001

Registration Form

Name(s): Date:

Address:

Home Phone: ( ) Alt. Phone: ( )

Email:

Dog’s Name: Dog’s Age:

Breed: M / F Spayed/Neutered Y / N

Where did you get this dog? Breeder that shows

Breeder that doesn’t show_____

Pet store

Rescue

Other

How do you describe this dog? Eager to please Happy-go-lucky__ __

Aloof Serious_____ Energetic_____

Playful_____ Average_____ Fearful_____

Worrisome _____ Mellow _____ Friendly _____

Other__________ ________________________

Has this dog ever bitten another dog or person? _____ If yes, please explain.

_______________________________________________________ _____

Is dog completely house broken?_________________________________

Is dog allowed on furniture?_____________________________________

Is dog crate trained?___________________________________________

Where is dog when you are home?________________________________

When you are out?_______________________________

When you go to bed?_____________________________

Feeding schedule: # of times per day:____ How much:________________

What kind of food:________________________________

Previous training this dog has had:_____________________ ___________

____________________________________________________________

Previous training you have had:___________________________ _______

____________________________________________________________

Concerns:_________________________________________ __________

Goals:_________________________________________ _____________

____________________________________________________________

Vet Records

Last rabies vaccine:___________________________

Last Dist-Hep-Lepto-Parvo-Para Vaccine:_____________________

Last Bordetella Intratrac (highly recommended):______________________

Other:_______________________________________________________

Vet records checked________

AGREEMENT TO HOLD HARMLESS,

WAIVER AND ASSUMPTION OF RISK

I understand that attendance of a dog obedience training class is not without risk to myself, members of my family or guests who may attend, or dog, because some of the dogs to which I will be exposed may be difficult to control and may be the cause of injury even when handled with the greatest of care.

I hereby waive and release “DANDY DOG TRAINING” dog school, its employees, officers, members and agents from which I or my dog may suffer, including specifically, but without limitation, any injury or damage resulting from the action of any dog, and I expressly assume the risk of such damage or injury while attending any training session, or any other function, of “DANDY DOG TRAINING,” I hereby agree to indemnify and hold harmless “DANDY DOG TRAINING,” its employees, officers, and agents from any and all claims by me, any training session or function of “DANDY DOG TRAINING,” or while on the grounds or the surrounding area there to as a result of any action by any dog, including my own.

Signature of Handler_____________________________________________________________

Date:___________________

Signature of any other adult accompanying you to class

______________________________________________________________________________

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