C&C PALS Class Registration Form
Class Information (check one)
| _____ Group Basic Obedience Class for Junior Puppies(5 months under) _____ Group Basic Obedience Class for Senior Puppies & Dogs (Over 5 months, no training) _____ Group "Shaping Up" Training Skills Class _____ Group Advanced Manners (For dogs with at least 1 year previous positive obedience training) _____ Group Outdoor Adventures: Leaving Tracks All Over Town Class _____ Group Foundation for Dog Sports & Competition Obedience/Rally Class |
_____ Group Agility I Class _____ Group Agility II Class _____ Group Tricks Class _____ Private Lesson Series _____ Private Behavior Consultation _____ Other (specify) |
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Start Date & Time ________________________________________________________________________________
Owner Information
Name__________________________________________________________________________________________
Address _______________________________________________________________________________________
City, State, Zip Code______________________________________________________________________________
Home Phone ______________________________________Work/Cell (circle) Phones __________________________
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 Dogtopia 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!