CLASS REGISTRATION FORM
Puppy Classes
Puppy Manners (Level 1)_______ Puppy Manners 2(Level II):_____________
Basic Class: ________ Come Fore: _______________ Other: ____________________
Competition Obedience:
Attention:_________________ Novice:____________________ Other: ___________________
Agility
Class: _____________ Start date :______________ Time:_______
Name (Print)______________________________________________ Today’s date_____________
Dog’s Name __________________________Breed________________ Age___________________
Address________________________________ City______________________________________
State__________ Zip code__________ email____________________________________________
Phone #__________________ Work#_________________Cell#____________________________
Previous Training: ________________________________________________________________
Problems: _______________________________________________________________________
Release and Waiver of all liability and Indemnification Agreement:
In consideration of, and as an inducement to the acceptance of my application for attendance and participation in activities at The K-9 Connection, the undersigned hereby agrees to abide by the rules and regulations of the K-9 Connection. I expressly assume the risk while at The K-9 Connection, including specifically but not without limitation, any injury or damage resulting from the action of any dog. I hereby agree to indemnify and hold harmless the above named facility, and their instructors and assistants from any and all claims or claims by members of my family as a result of any action by any dog, including my own.
Signature: _____________________________________________________ Dated: ______________________________
Received by K-9 Connection(date): __________________________________
For K-9 Connection Files:
Proof of Vaccination:
Rabies ________________ Date:________________
Parvo _________________ Date: _______________
Distemper _____________ Due_________________
Kennel Cough __________ Due_________________
Please make checks payable to The K-9 Connection and send to 60 Minnesota Avenue, Warwick, RI 02888. A $30.00 deposit will hold your place in a class. All deposits are non-refundable but may be transferred to another class.