Obedience Class Registration Form
Pre-Registration Required
$25 deposit or complete $85 fee payable to Sandra W. Ling
7411 Chapel Road, Madison, Ohio, 44057
Owner Name:_________________________________________________
Address:_____________________________________________________
Home/Cell Phone:____________________Email:_____________________
Dog Name:_______________Breed:_______________Neutered?________
Dog’s Age: ___________ How long have you had your dog?__________
Has he growled/bitten anyone?_____Explain_________________________
Dog problems at home?__________________________________________
Veterinarian?__________________________________________________
Do you or your dog have any disabilities or medical conditions that may affect your training?
____________________________________________
I understand attendance at a dog obedience class is not without risk to myself, members of my family, guests or
my dog as some dogs may be unpredictable, even when handled with the greatest of care. I hereby waive and
release Suburban Dog Training LLC and Sandra W. Ling, employees, volunteers or agents from any liability for
injury or damage that I, my family/guests, or my dog may suffer, and I assume the risk of such damage caused by
myself, family/guests or my dog.
Signed:___________________________________________Date:_______
Office Use: Puppy____Basic____Adv.Ob.____CGC____Other_____
Form of payment: Deposit__________Chk.#_________Cash_______
Balance Due_________R’cd.Chk#_______Cash______Date______
|
|