K9 Etiquette Training Class Registration

Select Class (just one) Deposit Total Fee Class Length
Puppy Socialization $65 $130 5 weeks
Canine Obedience $65 $130 5 weeks
Level 2 Canine Obedience & Basic Impulse Control $65 $140 5 weeks
Level 2 Impulse Control $65 $140 5 weeks
Tricks for Fun $50 $105 4 weeks
Outdoor Agility for Fun $50 $105 4 weeks

This registration form is for "_________________" Classes are held at 59 Bridge St South Hadley MA starting ____________ at _________________.

Class Fee: $_________. A non-refundable deposit of $_________ is required for a held spot in class.

Owner's Name: _________________________________________________

Address: ______________________________ City: ___________________

State: _______ Zip: ____________ Email: ____________________________

Home Phone: (____)_____________ Alternate Phone: (____)______________

Dog’s Name: ____________________ Breed: _________________________

Dog’s Age: _________ Sex: __________ Spayed/Neutered? No ____ Yes____

Please provide proof of animalís current vaccination history. Rabies and Distemper vaccines are required for class. Bordetella is suggested.

How did you hear about us? ________________________________

Please list anything you want covered in class: ____________________________________________________________________

Release of Liability

I, (owners name)_____________________________, as the legal owner of (Dog’s name) ____________________ do hereby waive and release, Susanne Shaw of K9 Etiquette from any and all liabilities of any nature. I agree to take complete responsibility for the actions of my dog, and myself before, during, and after class. At no time will the instructor of this class or owner of this facility be liable or responsible for the actions of myself, my dog, or anyone who accompanies me to class.

Signature of Owner: ____________________________________ Date: _____________________

Printed Name: ________________________________________