Online Registration

Full Name (Owner/Handler) *
Mailing Address *
City *
Zip Code *
Home Phone *
Cell Phone
Work Phone
Email Address *
Dog's Name *
Breed or Mix of breeds *
Dog's Age *
Gender
Spayed or Neutered? *	Yes No
Veterinarian or Animal Hospital You Use *
What class are you enrolling in? (Puppy, Beginners or Agility?)
What do you want to achieve in class?
Is your dog friendly towards other dogs? *
Is your dog friendly towards other people? *
How did you hear about Canine Connections? *
Where did you obtain your dog? (Please be specific)
How old was your dog when you got him/her?
Is this your first dog?	Yes No
What brand of food do you feed your dog?
Do you have young children at home? If so, what are their ages?
Are you using a crate at home?	Yes No
What problems are you having with your dog? *
Is your dog housetrained?	Yes No
What does your dog do if you take toys or food away from him?
Describe any physical problem your dog has.
Is there anything else you feel we should know about your dog?
I understand that attendance of a dog obedience training class is not without risk to myself, members of my family or guests who may attend, or my dog. Becuase 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 CANINE CONNECTIONS DOG TRAINING, hereafter referrred to as the "training organization," and its employees, officers, members and agents from any and all liability of 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 indemnity and hold harmless this Training Organization, its owner, employees, officers, members and agents from any and all claims, or claims by any member of my family or any other person accompanying me to any training session or function of the Training Organization, or while on the grounds or surrounding area thereto as a result of any action by any dog, including my own. *	Yes No