Class Registration Form

The workshop you wish to attend:

Recall workshopLead walking workshop

Your Name

Email address

Mobile phone number

Any mobility or other medical concern that may affect your ability to participate fully in the class?

Emergency Contact Name

Emergency Contact Phone Number

Area CodePhone Number

Your Dogs name

Dogs age when you acquired the dog

Dogs age now (years and months)

Dogs Gender

Neutered? Yes / No

Please describe your dogs general disposition:

e.g. lively, worried, lazy, energetic, feisty etc..

Has your dog ever bitten another dog or human?

YesNo

I understand that this class is not suitable for dogs that are reactive towards people or other dogs (e.g. showing behaviours such as barking, lunging, growling etc..)*

I understand

All dogs must be up to date on their vaccinations prior to attending the course and proof must be provided before Session 1. Photograph of vaccination card will suffice, sent by email to rvcanineservices@gmail.com. Titre test results will be accepted for dogs over 1 yr old as long as immunity is demonstrated.

My dog is fully vaccinated according to current veterinary standards Yes / No*

Waiver and Release:

As the legal owner of the above named dog I hereby waive and release Stephanie Penrose (Instructor), from any and all liabilities of any nature during class. I agree to take complete responsibility for the actions of my dog and myself, before, after and during each class.

I agree to keep my dog on lead unless directed by the Instructor and to follow the Instructors guidance while at class. At no time will the instructor of this class or lesson be responsible for the actions of myself, my dog or any other person who accompanies me to class.

Data Collection and Consent: Under the General Data Collection Regulation (GDPR) RVCS must obtain your explicit consent to collect and use your personal data, including but not limited to your name, address, phone number and email. By signing this form, you consent to the collection and use of your data in contacting you regarding dog training services suited to your needs. By signing this form you also agree to the waiver and release statement on this form. Your information will not be shared with any third party without your explicit consent in each instance. Signature:

Date

Please note: Refunds for cancelled places on workshops will only be provided where a minimum of 1 weeks notice is provided before the start date if session 1, or where the place can be filled by a person on the waiting list. Sessions missed due to non-attendance of a session will not be refunded.

The Ribble Valley Canine Services training classes are conducted by:

Stephanie Penrose

ABTC Registered Animal Training Instructor

ADipCBM, BSc (hons).

Contact: rvcanineservices@gmail.com Tel. 07572 923 220

RV Canine Services Ltd