TCKC Training Class Registration Form

PLEASE FILL IN COMPLETELY SO WE CAN EVALUATE YOUR DOG'S NEEDS AND TO ENSURE WE ARE AWARE OF ANY POTENTIAL PROBLEMS WITH THE DOG.

Name: _________________________________________________________________________

Address: _______________________________________________________________________

City: ________________________________________ State: _______________ Zip: _________

Email:____________________________________________________-

Phone number where you can be reached at 3PM: ______________________________________

Dog's Name: ____________________________________ Breed: ____________________ Sex: _______

Spayed: _____________ Neutered: _____________ Age: _____________

How long have you owned the dog? _______________________________

Description of Dog: _________________________________________________________________________________

Where did you get the dog? (Shelter, breeder, rescue, etc) _______________________________________________________________________

What kind of previous training: _______________________________________________________________________

Dog's History

Bite history: ________________________________  Fear History:________________________________

How is the dog around children____________________________________________________________

How is the dog around other dogs?__________________________________________________________

How is the dog around strangers? __________________________________________________________

Does your dog get groomed regularly? ________________________________________________________

Is there anything that you know of that may be a problem for the instructor? This is very important._____________________________________________________________________________

_____________________________________________________________________________________

Shot History

Rabies certificate: date expires: ____________ DHLPP: _____________________________________________

Veterinarian: ________________________________________ Phone: _______________________

I have read the class rules and understand them. I will abide by those rules.

Signed: ____________________________________________________ Date: ___________________