4 Week Class Registration Form

4-week Specialty Classes
Class Selection

Please choose the registration that responds to your assigned color. If you have any questions, please email deanna@ourcompanions.org. For more information, view our Color Coding for Success Infographic.
Please view our website for 4-week specialty class offerings and descriptions www.OurCompanions.org/Dogs/Dog-Training-Classes/

All Our Companions Behavior Programs follow a Pay-What-You-Can System, where clients can adjust the price of classes based on what they are willing and able to pay. The suggested price for this class is $95.
Select from Available Classes*
Client Information
Name*

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

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is there anyone else in who will be joining you in classes?*

YesNoMaybe
If yes, please list their names. Include ages if children.
Dog Information
Dog's Name*
Age (In Years)*
If under 1 year, please use approximate decimal notation.
Breed*
Where did you get your dog?*
How long have you had your dog?*
Is your dog Spayed/Neutered?*

YesNo
Does your dog have any medical concerns, injuries, or allergies that you would like us to be aware of?*

YesNo
If Yes, please explain:
What would you like to accomplish in this class?
What skills does your dog already know?
Does your dog have a history of fear, reactivity, or aggression towards people?*

YesNo
If Yes, please explain:
Does your dog have a history of fear, reactivity, or aggression towards other dogs?*

YesNo
If Yes, please explain:
Rabies Vaccination Agreement
Every dog participating in training programs at Our Companions Animal Rescue (OCAR) must be up-to-date on their Rabies Vaccination in accordance with Connecticut State Law. All clients are required to submit proof of vaccination before bringing their dog to class.
Is your dog currently Up-to-Date on their Rabies Vaccination?*

YesNo
If yes, what is the expiration date? *
Photo Release
Photos and videos are often taken of class participants and their dogs during training programs at Our Companions Animal Rescue and are often used in our social media posts, newsletters, promotional materials, websites, etc. It is important to us that we respect the safety, security, and personal rights of all of our community members.

Yes, I grant permission for OCAR to take photos/videos of myself, my pet(s), and property to use and publish these materials in both print and electronic media.No, I do NOT grant permission for OCAR to take photos/videos of myself, my pet(s), and property to use and publish these materials in both print and electronic media
Signature*

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Print Name*
Date*

MonthDayYear
Agreement to Hold Harmless
In consideration for participation in the training offered by Our Companions Animal Rescue (OCAR), I hereby assume all responsibility for any claim, loss or damage, of whatever kind or nature, whether to person or property, arising out of or related to this training. I further agree that I will hold OCAR, its officers, directors, trainers, volunteers, agents and members harmless and defend them from any and all liability for any injury, claim, damage or loss, of whatever kind or nature, whether to person or property, arising out of or related to this training. I agree to indemnify OCAR, its officers, directors, trainers, volunteers, agents or members who might be the subject of any claim, suit, loss or damage caused in any way by any act or negligence on my part or on the part of my dog during the Training Program.

I acknowledge that while OCAR may facilitate and sanction this training, OCAR does not have and does not exercise control of the conduct of my dog(s). I further recognize that OCAR is providing this training as a community service and utilizes volunteer trainers with varying levels of training experience. I also understand that the degree to which a dog is successfully trained is a function of the interest, commitment, and cooperation of the owner. I acknowledge and agree that there is no guarantee that my dog will achieve the desired level of training, despite the best efforts of the instructor. I also acknowledge that all information I have provided is factual, complete, and honest.
Signature*

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Print Name*
Date*

MonthDayYear
Payment Information

My Products*

4-Week Class Registration FeeFee for classes can be adjusted using the Pay-What-You-Can drop down below.

$95.00

Donation (Optional)Add a donation to support our canine behavior programs and help other pet families in need.

$25.00 Donation Amount

Enter coupon

Total

$0.00

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4-week Specialty Classes

Class Selection

Client Information

Dog Information

Rabies Vaccination Agreement

Photo Release

Agreement to Hold Harmless

Payment Information