TRI-COUNTY DOG TRAINING ACADEMY
P.O. Box 584 ~ Marinette WI 54143
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______________________________________________________________________
BIRTHDAY
_____________SEX_______________________________________
BREED___________
VETERINARIAN______________________________________________________________________
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
sponsor (s) or volunteer (s), 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 (s) 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
picture (s) 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)
Checks
will be deposited the second week of the session
you are enrolled in.
Do Not Write Below This
Line Do Not Write Below
This Line Do Not Write
Below This Line
____________________________________________________________________________________ Class:
Puppy
Beginners
I
Beginners II
Amount
$__.00
Check #
___
Cash___
Rabies______
Dhlp/Parvo___
Fecal Exam____
|