APPLICATION for BEGINNER LIFE SKILLS CLASS 1St October 2017 11:00Am

APPLICATION FOR BEGINNER LIFE SKILLS CLASS 1st October 2017 11:00am

First name: ______Surname:______

Full address: ______Postcode:______

Telephone:______E-mail:______

Dog's Name:______Age at start of class :______Male / Female: ______

Breed: ______How long have you had your dog? ______

Where did you purchase/adopt your dog from:______

Does your dog have any medical conditions? ⃝ Yes ⃝ No (Please specify) ______

Food (Please specify brand): ______When fed:______By Whom: ______

I confirm that my dog has been fully vaccinated & wormed appropriately ⃝ Yes ⃝ No

Details of other family pets? ______

Previous experience with dog training, please specify : ______

Do you have any disabilities that I need to know about? ⃝ Yes ⃝ No (Please specify) ______

How many people live with the dog? (If children, specify ages) ______

What would you like to learn in this class? ______

Please describe your dog's character in a few words:______

Is your dog very nervous of dogs? ⃝ Yes ⃝ No (If Yes Please specify) ______

Is your dog very nervous of people? ⃝ Yes ⃝ No (If Yes Please specify) ______

Is your dog generally very nervous? ⃝ Yes ⃝ No (If Yes Please specify) ______

Does your dog sometimes bark or growl at dogs? ⃝ Yes ⃝ No (If Yes Please specify) ______

Does your dog sometimes bark or growl at people? ⃝ Yes ⃝ No (If Yes Please specify) ______

Has your dog ever bitten or tried to bite a dog? ⃝ Yes ⃝ No (If Yes Please specify) ______

Has your dog ever bitten or tried to bite a person? ⃝ Yes ⃝ No (If Yes Please specify) ______

Where did you hear about Believe In Magic?______

In Case of Emergency Contact : Name ______Relationship______Contact No.______

Thank you for completing this form. Please return it by email to together with your payment.

Payment:(to be sent with registration) £120 for the 6 week class *

Please pay by BACS Sort code : 30-96-29 Account no. : 11644260Name : Eryn Martyn-Godfrey Reference : Your Dog's name

It is important to register in advance as there are limited places available in each class.

* Refunds can only be given if the course has been cancelled at least 14 days before the starting date. Course fees are not refundable once a course has started, if the owner cannot or does not want to attend any (further) classes.