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2023 Obedience Class Registration
Thank you for signing up to join HSWM's Behavior Program with your dog!
17
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1
Owner's Name
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First Name
Last Name
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2
Email
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example@example.com
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3
Phone Number
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Area Code
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4
Address
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Street Address
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City
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Saint Barthelemy
Saint Helena
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Saint Lucia
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Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
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Tristan da Cunha
Tunisia
Turkey
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Turks and Caicos Islands
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Ukraine
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Vietnam
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Isle of Man
US Virgin Islands
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Western Sahara
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Zambia
Zimbabwe
Other
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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5
Dog's Name
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6
Dog's Age
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7
Dog's Breed
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8
Dog's Gender
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9
Name of Veterinarian or Clinic
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10
Did you get your dog from Humane Society of West Michigan?
*
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Yes
No
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11
Have you been through an obedience class before?
*
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Yes
No
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12
If yes, where?
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13
Are you experiencing any specific behavior problems you would like to address with us?
*
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14
Canine Vaccination Records:
*
This field is required.
To attend a class at HSWM a copy of each of the following vaccination records are required: 1. Bordetella 2. Distemper 3. Rabies Please upload them below. If for any reason your vet has suggested waiting on any of the above shots or they are not yet completed, please email obedienceclass@hswestmi.org.
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15
Products & Payment
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Please note: The number/letter codes (i.e. T1, H3, W6) are for staff reference only.
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ORDER SUMMARY
Total cost
USD
Elementary School: Manners Matter (M3)
Mondays 4/17 - 5/22/2023 from 7:15-8:15pm
$
125.00
+
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Elementary School: Manners Matter (M4)
Mondays 7/24 - 8/28/2023 from 7:15-8:15pm
$
125.00
+
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Kindergarten: Boosting Good Behaviors (T3)
Tuesdays 4/18 - 5/23/2023 from 6:00-7:00pm - Up to 6 Months Old
$
125.00
+
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Kindergarten: Boosting Good Behaviors (T4)
Tuesdays 7/25 - 8/29/2023 from 6:00-7:00pm - Up to 6 Months Old
$
125.00
+
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High School: Jocks (T3)
Tuesdays 4/18 - 5/23/2023 from 7:15-8:15pm
$
125.00
+
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High School: Jocks (T4)
Tuesdays 7/25 - 8/29/2023 from 7:15-8:15pm
$
125.00
+
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Elementary School: Manners Matter (W3)
Wednesdays 4/19 - 5/24/2023 from 6:00-7:00pm
$
125.00
+
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Elementary School: Manners Matter (W4)
Wednesdays 7/26 - 8/30/2023 from 6:00-7:00pm
$
125.00
+
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Middle School: Manners Refined (W3)
Wednesdays 4/19 - 5/24/2023 from 7:15-8:15pm
$
125.00
+
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Middle School: Manners Refined (W4)
Wednesdays 7/26 - 8/30/2023 from 7:15-8:15pm
$
125.00
+
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High School: Jocks (H3)
Thursdays 4/20 - 5/25/2023 from 7:15-8:15pm
$
125.00
+
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High School: Jocks (H4)
Thursdays 7/27 - 8/31/2023 from 7:15-8:15pm
$
125.00
+
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Kindergarten: Boosting Good Behaviors (H3)
Thursdays 4/20 - 5/25/2023 from 6:00-7:00pm - 6-12 Months Old
$
125.00
+
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Kindergarten: Boosting Good Behaviors (H4)
Thursdays 7/27 - 8/31/2023 from 6:00-7:00pm - 6-12 Months Old
$
125.00
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16
Disclaimer
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Please sign below to accept the terms and conditions. Note: Owners are required to send proof of vaccinations for Distemper, Bordetella & Rabies. A current Titer test is also acceptable. Places in class can only be held if both payment and proof of vaccinations are received. Important: For the protection of your pet and others do not bring your dog to class if he has recently been sick (coughing, vomiting, diarrhea, mange, etc.). This is also true for female dogs in heat. Please leave the dogs at home, but you are encouraged to attend class so you can have the information to practice during the week. Children and young adults are welcome, but must be accompanied by an adult. In consideration of my enrollment in Humane Society of West Michigan classes, I hereby agree to assume any and all liability for any real or personal loss or injury, property damage, or injury or damage to any dog, person, or property, which may be caused by the dog I bring to class. I further agree to assume any and all liability and hold harmless the instructors of the program and its landlords or sponsors from any such occurrence or liability. I further state that my dog is properly vaccinated.
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17
We love dogs, but please verify that you are human!
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Please check you email for confirmation after submitting this form. If you do not see your confirmation please check your spam folder.
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