New Dog & Handler Registration Form
Please answer truthfully and to the best of your knowledge so we can offer you the best training experience possible.
About You
Your Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
Town / City
Post Code
Contact Number
*
-
Contact Email
*
example@example.com
Handler Name if not the owner (Under 18's MUST be accompanied by a responsible adult)
First Name
Last Name
Emergency Contact Name
*
Must be Over 18
Emergency Contact Number
*
Are you a first time dog owner?
Please Select
Yes
No
What training experience do you have?
Please Select
None
Basic
Intermediate
Advanced
About your dog
Your Dogs' Name
*
Breed of dog (if known)
Kennel Club Name if KC Registered
Your Dogs Date of Birth (if known)
-
Day
-
Month
Year
Is your dog male or female?
Please Select
Male
Female
What stage of training are you at with your dog?
*
No Training / Very Basic
Beginner
Intermediate
Advanced
Is your dog a rehome or rescue?
*
Neither
Rehome
Rescue
If rescued or rehomed, how long have you owned your dog?
Not Applicable
Between 0 - 6 months
Between 6-12 months
12 months +
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Has your dog been vaccinated against Distemper, Leptospirosis, Hepatitis & Parvo-Virus?
*
Yes
No
If 'No,' do you use a homeopathic alternative? If so, what do you use?
Is your dog registered with a veterinary practice?
Yes
No
Are you experiencing any behavioural issues with your dog?
Yes
No
If ‘Yes,’ Please describe the behaviour that is concerning you. e.g. biting; resource guarding; displaying anxious behaviour around other dogs or people; jumping up; failing to come when called etc.
Has your dog ever shown signs of aggression towards people or other dogs?
*
Yes
No
If ‘yes,’ please give details e.g. bitten a person or another dog and in what situation? Was it serious? (please note this does not mean your dog cannot attend classes, but we need to ensure every dog and handler is safe at all times)
Is there anything else you feel we should know about your dog, e.g. medical conditions; allergies; fear of strangers etc.
Do you as a handler have any specific requirements that you think we should know about? Such as accessibility requirements? Difficulty with mobility, hearing or anything that could affect your ability to train your dog? If so, please tell us how we can help.
GDPR Declaration
We will need to store information about you and contact you in order to manage your membership and organise club training and events.
I give my permission for Petersfield and District Dog Training Society to store my details for the above reasons
*
Please Select
Yes
No
I give my permission for Petersfield and District Dog Training Society to notify me about club training events:
*
Please Select
Yes
No
Petersfield and District Dog Training Society may use images of me or my dog(s) for social media purposes or for our website
*
Please Select
Yes
No
Handler Declaration
*
I agree to abide by the rules of the Society and the Kennel Club Code of Conduct. These can be read at: https://www.thekennelclub.org.uk/about-us/about-the-kennel-club/the-kennel-club-rules-regulations-and-codes/the-kennel-club-code-of-conduct/
Signed
Date
/
Day
/
Month
Year
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