CLASS ENROLLEMENT*: class enrolling in Puppy Class Starting April 26, 2008 Puppy Class Starting May 31, 2008 Basic Obedience Starting April 27, 2008 Basic Obedience Starting June 22, 2008

Owner's Name*:

Home Phone*: Cell Phone:

email*:

Address:

Dog's Name: Breed:

Age: Altered: Intact: Sex:

Veterinarian: Phone:

PLEASE BRING YOUR DOG'S SHOT RECORD FOR ADMISSION TO YOUR FIRST CLASS!

Below is a list of the most common reasons why dogs need training. Please check the ones which best describe your furry friend.

1. He/She is so friendly - He/She lunges & jumps upon greeting people


2. He/She gets so excited meetings dogs - He/She pulls the leash hard


3. He/She gets so excited meeting dogs - He/She whines and barks alot


4. He/She is always nergetic & hyper - He/She never obeys my commands


5. He/She loves to chase other animals like squirrels, cats or bunnies


6. He/She loves to chase vehicles, joggers, bikers, scooters and/or ATVs


7. He/She is unhappy around children & lunges, growls and/or barks at them


8. He/She is afraid of strangers & often exhibits submissive urination


9. He/She is unhappy with men and is often agressive and sometimes bites


10. He/She always hates other dogs and will growl, chase and/or attack them


11. He/She is always kept outside in the back yard or tied to a dog box


12. He/She is very strong and always pulls the lead too much during walks

Thank you very much for your information. BE sure to bring materials and clean up after your dog should He/She need a potty break while at Keepstone Farm.

By submitting this form, you agree to the following:

• You will promptly mail the appropriate fee for the training classes enrolled.


• Checks will be made out to Audrey Harrison and mailed to the address on the remittance form.


• There is an additional $50.00 charge for checks returned for non-sufficient funds and in that case, you understand that you will be held accountable for such a charge.


• As a participant of this dog training group, you hereby assume all risk and responsibility for all accidents and damage to yourself and to your own property or loss thereof due to the actions of your dog, and


• you agree that under no circumstances shall any person(s) or instructor(s) be held liable for any and all damage and injury resulting in bodily harm to yourself or for loss or injury to your property whether due to uncontrolled livestock or animals of any kind or negligence of any person(s) or instructor(s) of said group or any other causes or reasons.

I agree and acknowledge all terms reference herein:*