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ABC
Obedience Dog Training & Pet Supplies
2458 Boston Post Road.
Guilford, CT 06437
(203) 458-2223. FAX:
(203)468-8144 "box 185" (fax is off site)
office/retail hours: Mondays
3-6, Thursdays 12-6, Sundays 11-1
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Group
Class Registration Questionnaire
send
to ABC Obedience by fax or mail (info above). Registration
may also be done by phone with credit card. Click here to for secure
on-line registration
Circle one:
Puppy
Kindergarten Beginner
Puppy
Beginner Adult Other:
____________________________________
Class Start date: __________
Time:__________
Today's date: __________
Owner's name: (last, first)
_______________________________________________________________________
Address:___________________________________________
City: _______________ Zip: __________
e-mail:___________________________
Phone #: (h)________________
(w) ________________ Occupation: _________________________________
Dog: Name:
___________________ Sex ___ Breed:______________________
Age:_______ Date of
birth ______ How long owned? ______
Veterinarian (& city):
___________________________________________
Inoculations: rabies
________ distemper/parvovirus __ Kennel cough?__
Neutered/spayed? ____ (when?
_____) Aggressive behavior? ___
Ever bitten? ___ If
so, explain: ____________________________________
How did you hear about ABC
Obedience? ________________________________________
Previous training? ___________________
Any comments or behavioral
problems you would like addressed?
_______________________________________________________________________________________________________
Please read and acknowledge
by signing below: "I am registering for a group class with ABC
Obedience dog training. I understand that there is a non-refundable
fee to be paid in full before the first session to ensure my enrollment
in the class. I certify that to the best of my knowledge my dog is
free from disease, properly vaccinated and in reasonably good health.
I further state that my dog has not bitten anyone nor has any history of
overly aggressive behavior unless otherwise specified. I understand
that I am responsible for any damage done by my dog and that training will
be terminated if the animal is found to be a threat to personal safety.
I also understand that effective obedience training is a function of repetition
and consistency. I will therefore to the best of my ability adhere
to the recommendations made to insure the most effective training for my
dog".
_____________________________________________________
____________________
Pet owner's signature
Date
If paying by credit card:
MC/Visa #_ _ _ _ - _ _ _ _ - _ _ _ _ - _ _ _ _ Exp.
__ __ / __ __
V-code (last 3 digits on
BACK in signature box) _ _ _
signature for authorization
to charge: ___________________________________________________
Amount: $ ___________ |