Dog Training Class Registration Form

Mount Pleasant Kennels

Dog Training Class Registration Form

Owner Information

First Name
Last Name
Email
Telephone
Address
Post Code

Which training class or classes are you registering for (please mark with X)

Class / Start Date / Individual Class / Program of 5 Classes
Puppy Party
Puppy Basic Training
Basic Training
Zero Impact Agility
Impact Agility
121 Training

Dog Information

Dog Name
Breed
Age
Gender
Neutered Y/N
How long have you owned your dog?
Where did you get him from (Breeder, Rescue etc)

Dog Medical History:

Please note that all dogs joining our classes MUST have up to date vaccinations, kennel cough vaccination is also preferred. Dogs must be free from infection when joining a class, and be free from fleas or worms or anything contagious or transferrable onto other dogs. (Vaccination cards will need to be brought to your first training class)

Has you dog currently got or ever had any of the following: If answering yes, please include as much detail as possible.

Any joint problems?
Any respiratory or heart problems?
Diabetes?
Epilepsy?
Allergies?

Dog Behaviour. How would you best describe your pooch?

Mark ‘X’ to all that apply to your dog.

Separation Anxiety
Defensive of you or anyone in the household
Confident
Fearful of meeting new people
Fearful of meeting other dogs
Loves treats
Guards toys/food or other
Likes to play with toys/ball
Chilled out (relaxes well)
Constantly on the go
Picky Eater
Reserved/Shy
Timid
Tires Easily
Housetrained
Reacts well to traffic noise

Have you done any training with your dog in the past prior to these classes?

Do you have any concerns about your dog being in a group setting with other dogs?

Any other relevant information:

Payment is due at time of booking and can be made via credit/debit card over the phone. Refunds can be made for cancellations (please see our website for details)

Waiver & Release:

I, the undersigned, warrant that I have given all information pertaining my dogs health, history and behaviour in order to ensure that I do not put myself, my dog or others at risk of disease or injury.

I also undertake in signing this agreement that I fully understand that there are risks involved when working with dogs, they can be unpredictable and as a dog owner I am fully responsible for the behaviour and actions of myself and that of my dog. I also understand that there will be off lead work at some stages during training and this may be in a group class or in 121 classes. I understand that the training area at Mount Pleasant Kennels although secured by fencing, is adjacent to a busy main road and I have considered this when choosing this class for my dog.

Mount Pleasant Kennels accepts no liability whatsoever for any personal injury, loss or damage to either yourself, your property or your dog whilst participating in any of our training classes. Nothing in this agreement excludes or limits liability of either Party for death or personal injury caused by negligence or fraudulent misrepresentation.I am over the age of 18 and have appropriate authority to sign this agreement

Print Name ______Date ______

Signature ______