Training Class Enrollment Form

Training Class Enrollment Form
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Dog Name
Breed/Breed-type
Color
Sex

FemaleMaleSpayed FemaleNeutered Male
Weight
Date of Birth/Age
Adoption Date
Does this dog currently attend our daycare program?

NoYes
Are you a current client with another dog in our daycare program?

NoYes
Do you plan to enroll your dog in our daycare program?

NoYes
If Yes, when?
Does your dog have any allergies

NoYes
If yes, please explain
List any previous training this dog has had.
List any physical limitations this dog has.
Is your dog aggressive to people?

NoYes
Is your dog aggressive to other dogs?

NoYes
Why are you pursuing training classes at this time?
The Levels class enrollment fee is $150.00. Payment is required to hold your place in class. Payment must be made prior to the first class and payment cannot be accepted by your instructor on the night of class. We are open Monday - Friday, 6:30 am to 6:00 pm. You may pay in person during those hours or we can take credit card information by phone, at 698-1200.
Vaccination records are required prior to starting class. You can upload a copy below or you can drop a copy off during our open hours. You can also mail to 310 Carver Ln, East Peoria, IL 61611

NOTE: If you are a current daycare client, we have your vaccinations on file, so no need to send.
Upload vaccines here

Cancelof
I state that I am the owner of the dog named in this application and that this dog is not a hazard or menace to other dogs or people. I further state that I am responsible for any injuries to people, dogs, or damage to property caused by my dog. I understand that my dog will not be admitted to class without proof of current vaccinations.

Clear
Thank you for your interest in our classes. We will be in touch within 24 hours after receiving your enrollment form. If you do not hear from us in that timeframe, please check your SPAM folder. If nothing there, please follow up with us.
Should be Empty:

Training Class Enrollment Form

Vaccination records are required prior to starting class. You can upload a copy below or you can drop a copy off during our open hours. You can also mail to 310 Carver Ln, East Peoria, IL 61611

Thank you for your interest in our classes. We will be in touch within 24 hours after receiving your enrollment form. If you do not hear from us in that timeframe, please check your SPAM folder. If nothing there, please follow up with us.