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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: ___________________ |