The Canine Connection Dog Training, LLC - Dog Training Class Schedule and RegistrationThe Canine Connection Dog Training, LLC
Registration Form

Type of Class____________________ Starting Date _______________ Time_______________

RABIES shot date____________ Attach certificate copy or note date or tag# _____________

Owner’s Name(s)__________________________________________________________________________________________
Street Address__________________________________ City__________________ State______ Zip_________
Phone :Home__________________ Work/cell___________________ E-mail: ___________________________________________
Dog's Name:____________________ Breed:_________________ Sex: ______ spayed/neutered?________
Dog’s date of birth____________ How old was your dog when you got him/her? _____ Where did you get your dog?________________________________ Have you ever trained a dog before?_______ Have you attended any other classes here?: Yes: ___ No:___ What do you feed your dog?________________   Do either you or your dog have any physical handicaps or disabilities which may affect training? ______ ____________________________________________________

Circle words which apply to your dog or write in :

Growls               Pushy                           Hyper                  Not Housetrained                                      Aggressive- to people

                 Shy               Bites                              Dominant                            Too Attached To Me                     - to dogs

Fearful            Destructive                      Noisy

other:_________________________________________________________________________________________________

Percentage of time your dog is: Outside ____% Inside____% Crated ____% Without humans ____%

What do you like best about this dog?__________________________________________________

What does your dog already know?____________________________________________________

Who is your Vet?___________________ Date of your dog's last distemper/parvo shot___________
How did you hear about our classes?__________________________________________

Please read and sign the release below:

*Waiver, Assumption of Risk and Agreement to Hold Harmless*

I understand that attendance at a dog obedience class is not without risk to myself, members of my family or guests who may attend, or my dog, because some of the dogs to which I (we) will be exposed may be difficult to control and may be the cause of injury even when handled with the greatest of care.

In consideration of, and as an inducement to, the acceptance of my registration for classes, I agree to indemnify and hold harmless, and hereby waive and release the school, its employees, owners or agents from any and all liability of any nature, for injury or damage which I, my family or guests or my dog may suffer, including specifically, but without limitation to, any injury or damage resulting from the action of any dog including my own, and I expressly assume the risk of any such damage or injury while attending any training session or other function of the school, or while on the school grounds or in the building.

I also understand that the degree to which a dog is successfully trained is a function of the interest, commitment, and cooperation of the owner. I acknowledge and agree that there is no guarantee that my dog will achieve the desired level of training, despite the best efforts of the instructor.

Signature______________________________________________________Date________________

Signature______________________________________________________ Date________________

Please have all members of your family who will be attending class sign. Use back if necessary.
Send registration and deposit to:
Canine Connection Dog Training, LLC , 194 Bridgeport Ave, Milford, CT 06460 (203)876-2441
[email protected]
Class fees are not refundable after the start of class.
Thanks and happy training!