Ready, Vet, Go! Registration Form

Ready, Vet, Go! Program Registration

Have you ever wondered what working in a veterinary clinic would be like? Ready, Vet, Go! is a one-day mentorship program designed to give you an opportunity to shadow a Veterinarian and experience real-world medical cases as you build your future in veterinary medicine. The Paws Humane Veterinary Clinic is a fast-paced, high-volume spay/neuter clinic. Each day we average 35 spay/neuter surgeries and 60 wellness appointments. With three full-time veterinarians and a hard-working staff of veterinary technicians, there’s never a dull moment. While shadowing the Veterinarian, you will have the opportunity to witness what it takes to work in the veterinary field and experience the joys of helping animals in need.
Student's Information
Last Name*
First Name*
Gender*

MaleFemale
Address*
City*
State*
Zip*
Birth Date*

MonthDayYear
Parent or Legal Guardian Information

Only needed if you're under the age of 18.
Parent/Legal Guardian
Relation
Work Phone

Area CodePhone Number
Cell Phone

Area CodePhone Number
Parent /Legal Guardian 2
Relation 2
Work Phone 2

Area CodePhone Number
Cell Phone 2

Area CodePhone Number
Home Phone

Area CodePhone Number
Emergency Contact Info
Emergency Contact Name
Emergency Number

Area CodePhone Number
Emergency Number #2

Area CodePhone Number
Email Confirmation
Email*
Other
I understand that Paws Humane Society has the right to dismiss any student for unsatisfactory behavior or performance at any time. *
I understand that Paws Humane Society does not provide lunch for any students. *
Health Information
Are immunizations up to date?*

YesNo
Date of last tetanus shot*
Any activity the student should be restricted from?*
Any physical, mental or other condition that would require special attention or medication while at Paws Humane Society?*
List any allergies (ex: bees, dairy) Anyone with animal related allergies OR peanut allergies is not recommended to participate.*
Ready, Vet, Go! Shadow Date

Currently, Ready, Vet, Go! is offered only on Wednesdays, you'll be contacted by a staff member within 24 hours to schedule an exact date with you. All program times are 9am - 4pm. Dates are non-refundable, so please be sure you can attend BEFORE signing up!
Payment Information

$225 Registration Fee Due

Registration Fee*

Ready, Vet, Go Program$225.00

Quantity

Total $0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

By hitting submit and putting your initials, you agree that you are the parent or legal guardian of the above named student, and are over the age of 18 OR you are a person over the age of 18. In case of medical emergency or general medical care, I give consent for medical teatment for the by authorized personnel.

I fully understand there are risks and dangers associated with working with wild, feral and domesticated animals, including but not limited to, bites, scratches, zoonotic diseases (diseases transmitted from animals to humans), and allergic reactions. I fully understand and accept those risks and dangers. Paws Humane Society will limit, heavily supervise, and sometimes end animal-student interactions.

I will adhere to the Paws Humane Society, Inc.’s Program Handbook and guidelines.
Electronic signature, please initial*
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Ready, Vet, Go! Program Registration

Student's Information

Parent or Legal Guardian Information

Emergency Contact Info

Email Confirmation

Other

Health Information

Ready, Vet, Go! Shadow Date

Payment Information