ULTIMUTT Barn Hunt Registration

Ultimutt Barn Hunt Registration
Name*

First NameLast Name
Phone Number*
Email*
example@example.com
Dog's Name*
Dog's Date of Birth*

MonthDayYear
Date. If unsure, please guess approximate Date.
Breed and Color
VACCINATIONS

We recommend the following Vaccinations. If your dog doesn't have all these please explain in the explanation below.
- • *Bordetella (the intranasal 6 month that includes Adenovirus, Parainfluenza, and Bordetella is highly recommended)
- • *Canine Influenza (H3N2 or H3N2/H3N8.The combination vaccine is highly recommended.
- • Rabies 1 year or 3 year (once old enough for puppies)
- • DHLPP annual or equivalent (or puppy series)
*The first two are not part of the regular vaccines routinely given and have to be asked for. Your dog must have the second Flu Shot before attending daycare.
My dog is current with the following vaccinations:*

RabiesBordetellaCanine InfluenzaDHLPP annual or equivalent (or puppy series)My dog is Titered for some of the above shots
Vaccination explanation - if your dog doesn't have all the required vaccinations
Which best describes your dogs energy level?*

LowMediumHIgh
Are there any types of PEOPLE that your dog dislikes? Please explain.*
If Not, type None
Are there any types of ANIMALS that your dog dislikes? Please explain.*
If Not, type None
Has your dog ever bitten anyone?*

NoYesIf yes, please explain
Does your dog had any Barn Hunt experience?*

NoYesif yes, how much?
Has your dog been in any Barn Hunt trials?*

NoYes
If Yes is marked above what is highest level? How many rats does your dog typically search for at a time?
Please provide other comments or information about your dog that you feel might be helpful:
How did you hear about us?*

Internet SearchFacebookInstagramFrom my VetWord of Mouth/From a FriendOther
Image Release*

I grant permission to post pictures of my dog(s) with their name on Ultimutt Knoxville website, on social media (Facebook, Instagram, etc.) and/or in other print and video/TV media related to Ultimutt Knoxville.I grant permission to post pictures of my dog(s) without their name on Ultimutt Knoxville website, on social media (Facebook, Instagram, etc.) and/or in other print and video/TV media related to Ultimutt Knoxville.Do not use my images at all
By e-signing this form, I accept the risks in the statements in the waiver above and I certify that the information provided in this form is accurate and true to the best of my knowledge. *

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Ultimutt Barn Hunt Registration