Group Class Form

Which class are you registering for?

Owner Information

Full Name*

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number*

Area CodePhone Number

E-mail*

How Did You Hear About Us?

Dog Information

Dog's Name*

Breed*

Age or DOB*

Gender*

MaleFemaleSpayed FemaleNeutered Male

Where Did You Acquire Your Dog?*

Veterinary Information

Veterinary Clinic

Is your dog up to date on the DAPP and Rabies vaccines?*

YesNo

Is your dog up to date on the kennel cough (Bordetella) vaccine?*

YesNo

Is your dog on flea/tick/parasite prevention?*

YesNo

All dogs MUST be up to date on DAPP and Rabies vaccines. We strongly recommend the Bordetella vaccine be up to date as well as a flea/tick prevention administere prior to starting class.

Encore Dog Training does not assume any liability for any illnesses acquired due to lack of preventive measures.

Vaccination Dates:

Rabies:*

DAPP:*

Bordetella:

A copy of vaccines records MUST be provided no less than 48 hours prior to the start of class. This can be a vaccination certificate from your clinic, an invoice from your clinic, or a veterinarian signed vaccine booklet.

Please email vaccine records to encore.dog.pg@gmail.com

I acknowledge and agree to the above statement regarding vaccinations.

YesNo

Please list any medications your pet is on. Type "none" if not applicable.*

Please list any health problems or concerns your pet has. Type "none" if not applicable.*

Behavior Information

Please list any prior training done with your dog:

Has your dog ever shown any aggression towards other dogs?*

YesNo

Has your dog ever shown any aggression towards people?*

YesNo

Is your dog nervous in new places or situations?*

YesNo

If you answered yes to any of the above, please describe.

Refund Policy

I agree that once payment for class is submitted, I am considered a registered participant, at which point no fee will be returned. Class fees may be transferrable at the discretion of the trainer in extenuating circumstances, but shall be considered on an individual basis.

AGREEMENT TO HOLD HARMLESS, WAIVER AND ASSUMPTION OF RISK

I understand that attendance of a training class is not without risk to myself, members of my family or guests who may attend, or my dog.

I hereby waive and release Encore Dog Training hereinafter referred to as the "Training Organization", its employees, officers, members and agents from any and all liability of any nature, for injury or damage which I or my dog may suffer, and I expressly assume the risk of such damage or injury while attending any training session, or any other function, of the Training Organization, or while on the training grounds or the surrounding area thereto.

In consideration of and as inducement to the acceptance of my application for training membership by this Training Organization, I hereby agree to indemnify and hold harmless this Training Organization, its employees, officers, members and agents from any and all claims, or claims by any member of any family or any other person accompanying me to any training session or function to the Training Organization, or while on the grounds or the surrounding area thereto as a result of any action by any dog, including my own.

By Clicking The Submit Button You Agree To The Above Terms

The fee for group classes is $199.50 CAD. Payment is accepted by etransfer, cash, visa debit, or credit card. How will you be paying? If you are paying by card, an invoice will be sent with a payment link once your registration form is received.*

E-transfer to encore.dog.pg@gmail.comCard paymentCash