On-line Registration For Group Classes

Please fill out ALL fields Which class would you like to enroll in?
What date would you like to begin class?
How did you learn about our classes?
Owner Information:
Name:
Address:
City:
State:	Zip:
Phone:
E-Mail:
Dog Information:
Dog's Name:
Breed:
Birth Date
Dog's Veterinarian:
Is your dog up to date on its vaccines and free of contagious disease?	Yes No
Has your dog been spayed or neutered?	Yes No
Gender:	Male Female
Will your dog be able to eat treats in a group class?	Yes No
Will your dog bark continuously in class?	Yes No
Which best describes your dogs reaction to meeting new people?
Which best describes your dogs reaction to meeting new dogs?
Are there any circumstances in which your dog has growled, snapped, bit, lunged or barked in an unfriendly fashion at people or other dogs? Yes No If yes, please explain:
Enrollment Policies Refund Policy – If you wish to check for compatibility, please visit a class (without your dog) prior to enrolling. Because work will begin on your behalf prior to the first class, refunds can only be provided if we are notified at least 72 hours before the first class. Please do not turn in your application if you have any hesitancy in honoring this refund policy. Make-up Classes and Training Commitment - Training requires a commitment so make-up classes are not offered. Written material, phone contact and private consultations are options. Enrollment is not transferable to another dog or party, but all immediate family members are welcome to attend class. Safety Policy - These classes are for dogs that do not snarl, growl, snap, lunge or bite in an unfriendly fashion and owners who are physically capable of safely handing their dog. Should a safety issue be discovered, you agree to forfeit this class and enroll your dog in a more appropriate program. Permission Granted - I permit The Well-Mannered Dog to use videos, photos or imagines and case history information of me & my dog in any way that benefits my dog, for educational and marketing purposes. Agreement To Hold Harmless, Waiver And Assumption Of Risk - I understand that attendance of a dog training class is not without risk to myself, members of my family, guests who may attend, or my dog, because some of the dogs to which I will be exposed may be difficult to control and may be the cause of injury even when handled with the greatest amount of care. I hereby waive and release THE WELL-MANNERED DOG, LLC hereinafter referred to as the “Training Organization”, its employees, officers, members and agents from any and all liability of any nature, for injury or damage which I or my dog may suffer, including specifically, but not without limitation, any injury or damage resulting from the action of any dog, and I expressly assume the risk of such damage or injury while attending any training session, or any other function, of the Training Organization, or while on the training grounds or the surrounding area thereto, In consideration of and as inducement to the acceptance of my application for training membership by this Training Organization, I hereby agree to indemnify and hold harmless this Training Organization, its employees, officers, members and agents from any and all claim, or claims by any member of any family or any other person accompanying me to my training session or function to the Training Organization, or while on the grounds or the surrounding area thereto as a result of any action by any dog, including my own.
Your registration will not be complete until I receive your payment for class. Please indicate how you will pay for class: Type your name into this box, to state you agree to these policies, permission granted statement, hold harmless waiver and indicate you want a spot in this class and to have your payment processed. Ok, type your name in the box and click submit

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