C&C PALS Class Registration Form

Class Information (check one)

Start Date & Time ________________________________________________________________________________

Owner Information

Name__________________________________________________________________________________________

Address _______________________________________________________________________________________

City, State, Zip Code______________________________________________________________________________

Home Phone ______________________________________Work Phone ____________________________________

Email__________________________________________________________________________________________

Dog Information

Dog's Name______________________________________Breed___________________________________________

Date of Birth_____________________________________ Breeder(if known)__________________________________

Age _______________Sex_____________ Neutered/Spayed?______________________________________________

Vaccination Date Information

Rabies______________________DHPP___________________Bordetella (Kennel cough)________________________

Vet Clinic/Vet_____________________________________________________________________________________

Problems
Has your dog ever bitten a person?__________ A dog?_________If so, how many times? Person_________ Dog________

Severity? (Scale 1 to 5) Person __________ Dog _________ (1= snapping at, not touching; 5 = several rips, tears or punctures)

Additional Comments:

_________________________________________________________________________________________________

Temperament
How would you describe your dog’s behavior with other dogs, i.e. aggressive, passive, rowdy, shy, etc.?

__________________________________________________________________________________________________

Goals
What are the primary areas of behavior that you would like to work on in this class and what are your goals from this class?

__________________________________________________________________________________________________

Do you plan on showing your dog in breed competition?___________ In obedience competition?__________ In other? (explain)

__________________________________________________________________________________________________

How did you hear about C&C PALS? _______________________________________________________________________

Registration
Please complete & mail the registration form, along with payment, to: C&C PALS 7790 Willow Point Dr. Falls Church, VA 22042 The form must reach us, with payment, prior to the start of the class to guarantee enrollment.

Cancellation Policy - Please Read Carefully
Classes are subject to rescheduling or cancellation. Should this occur you will be immediately advised of the next available class and/or offered a refund of any payment made. If you need to cancel your registration, please do so early. A cancellation after the start of class will incur a 100% cancellation fee. Once a registered dog has left the class, regardless of reason, the fee will be non refundable and non transferable. Once a class has started if you wish to move the registered dog to a future class this will incur an additional fee of 60% of the cost of the class, as this removes a space in the future class that could be sold at 100%. If there is a medical emergency with your dog, that prevents you from coming to the scheduled class, we will need a note from your vet. We will try to accommodate changes within limits of our class schedules and attendance.

PLEASE NOTE: C&C PALS reserves the right to excuse any dog from class that is exhibiting aggressive or inappropriate behavior.

Release
The undersigned acknowledges and agrees that his/her participation in dog obedience training involves some risk and he/she knowingly assumes all risk attendant thereto. The undersigned does herewith disclaim and indemnify and hold harmless the officers, directors, and employees of C&C PALS, LLC from any and all loss, damage, and expense caused by reason of his/her participation in dog obedience training.

All applicants must fill out and sign the Happy Tails Dog Spa Owners Agreement prior to first day of class. Please send in owners agreement along with C&C PALS application. See link below.

_____________________________________________________________Signature(s) ________________________ Date

We look forward to seeing you and your dog in class!

Happy Tails Dog Spa Owners Agreement