Pawsitive Training Zone
Therapy Dog Class Registration - Starts Sunday, December 7, 2025
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Dog's Name
*
Dog's Breed
*
Dog's Gender
*
Dog's Date of Birth
*
Vet Office (only used in event of an emergency)
*
Vet Office Name and Town
My Dog is current on the State of IL required shot of Rabies
*
Yes
No
Additional Information You'd like to share with me about your dog such as timid, etc.
Sunday 4 pm Class
Emergency Contact Person (in event of a medical emergency)
*
First Name
Last Name
Emergency Contact Phone Number (for whom I should contact in event of a medical emergency)
*
-
Area Code
Phone Number
Submit
Should be Empty: