return to Home Page

TRI-COUNTY DOG TRAINING ACADEMY
P.O. Box 584 ~ Marinette WI 54143

DHLP/Parvo   Rabies Bordetella     Fecal Exam
OBEDIENCE CLASS ENROLLMENT FORM
Please bring proof of up to date vaccination and the results of recent stool exam.

NAME ______ ______________________________________________UNDER 18? YES___NO___

(A PARENT OR GUARDIAN MUST ACCOMPANY CHILDREN UNDER 18)

ADDRESS_______________________________________________________________________

CITY _____________________________________________STATE________ ZIP_____________

TELEPHONE (_________)__________________________________________________________


NAME OF DOG____________________________________________________________________

AGE__________________BREED________________________________________ SEX_________


VETERINARIAN___________________________________________________________________

WHAT ARE YOUR GOALS?___________________________________________________________

HOW DID YOU HEAR ABOUT US?______________________________________________________

Tri-County Dog Training Academy reserves the right to excuse any dog that may pose a threat to the safety and well being of others.

In consideration of my participation in the Tri-County Dog Training Academy, I do hereby, upon my signature, agree to hold free from any liability, Tri-County Dog Training Academy, and any other sponsors or volunteers, and do hereby, for myself, heirs and executors and administrators waive, release and forever discharge any and all right and claims accrued to me arising out of or connected with my participation. I do, hereby declare myself and canine to be physically sound to participate in the Tri-County Dog Training Academy. I also understand and agree that Tri-County Dog Training Academy may subsequently use for publicity and/or promotional purposes, my name and /or pictures of my participating in this training without obligation or liability to me.

DATE______________ SIGNATURE____________________________________________________

MAKE CHECKS PAYABLE TO: T.C.D.T.A. - (Tri-County Dog Training Academy)

return to Enrollment Page