Registration Form

A Pawsitive Difference Dog Training School

Registration Form

 Dog Name:  ________________________

DOB:_________________________________

Breed:_________________________________

Behavior Issues:_________________________

History:________________________________

Proof of Vaccination:  yes    no

My Dog is        Male       Female       (please mark with an x)

My Dog is        Spayed          Neutered  (please mark with an x)

Has bitten before:                                                                 

Waiver, Assumption of Risk and Agreement to Hold Harmless

I understand that participation in dog training is not without risk to myself and my dog as well as any family members or guests who might attend. I hereby waive and release from any and all liability of any nature, for injury or damage suffered as a result of my participation in any class or private lesson, including any damage or injury resulting from the action of any person or dog, or for any accident occurring on the premises or its surroundings. I agree to accept full responsibility for my actions, those of my family or guests and those of my dog.

Owners name:_______________________        

Address:_____________________________     

Phone#:________________________________

E-Mail:________________________________

Signature:___________________        Date:­­­­­­­­­­­­­­­­­_________

How did you hear about A Pawsitive Difference?

 Please notify 48hrs in advance of any cancellation.