Registration

C&C PALS Class Registration Form

(* indicates mandatory fields)

* Indicates required field

Class Information (select one) *

Class Location *

Class Date *

Class Time *

Owner's Information

Owner's Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Home Phone *

Cell Phone *

Work Phone *

Email *

OK to share email with ODHA Center *

Yes No

Dog's Information

Name *

Breed *

Date of Birth *

Breeder (if known) *

Age *

Sex *

Female Male

Neutered/Spayed? *

Yes No

Vaccination Date Information

Rabies *

DHPP *

Bordetella (Kennel cough) *

Canine Influenza *

Vet Clinic/Vet *

Problems

Has your dog ever bitten a person? *

Yes No

A dog? *

Yes No

If so, how many times? Person *

Dog *

Severity? Person *

Dog *

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? *

Yes No

In obedience competition? *

Yes No

In other? (explain) *

How did you hear about C&C PALS? *

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 check that you have read and agree with the above cancellation policy. *

Agree

PLEASE NOTE: C&C PALS reserves the right to excuse any dog from class that is exhibiting aggressive or inappropriate behavior without any refund.

Release

By submitting this form you acknowledge and agree that your participation in dog obedience training involves some risk and you knowingly assume all risk attendant thereto. You likewise 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 your participation in dog obedience training.

COVID-19 Waiver

I acknowledge the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing.

I further acknowledge that C&C PALS, LLC has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19.

I further acknowledge that C&C PALS, LLC cannot guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, C&C PALS staff, and other clients and their families.

I voluntarily seek services provided by C&C PALS, LLC and acknowledge that I am increasing my risk to exposure to the Coronavirus/COVID-19. I acknowledge that I must comply with all set procedures to reduce the spread while attending the class.

I attest that:
* I am not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.
* I have not traveled internationally within the last 14 days.
* I have not traveled to a highly impacted area within the United States of America in the last 14 days.
* I do not believe I have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19.
* I have not been diagnosed with Coronavirus/Covid-19 and not yet cleared as non-contagious by state or local public health authorities.
* I am following all CDC recommended guidelines as much as possible and limiting my exposure to the Coronavirus/COVID-19.

I hereby release and agree to hold C&C PALS, LLC harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of the company, or that may otherwise arise in any way in connection with any services received from C&C PALS, LLC. I understand that this release discharges C&C PALS, LLC from any liability or claim that I, my heirs, or any personal representatives may have against the company with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any services received from C&C PALS, LLC. This liability waiver and release extends to the training center together with all owners, partners, and employees.

Please check that you have read and agree with the above Release and Waiver statements. *

Agree

Please check that you agree the above information is accurate and complete to the best of your knowledge. *

Agree

Submit