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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