Wednesday 11:00 am Puppy Class
Fill out the form carefully for registration
Student Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student E-mail
*
example@example.com
Mobile Number
*
Phone Number
Dog's Name
Dog is M/F
Please Select
Male
Female
Dog's Age
Dog's Breed
Veterinary Clinic
Copy of Vet Records - REQUIRED to attend class. If you can't upload here, contact Colleen at Lilaccitydtc@gmail.com
*
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*We do not keep copies of client's vet records.
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I assume full responsibility for any actions of the dog entered above and agree to absolve the Lilac City Dog Training Club and trainers off all liability resulting from the actions of the dog, handler, and/or owner on the premises of the Lilac City Dog Training Club. Sign Below using your finger...
*
(If under 18, Signature of Parent/Guardian)
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