Registration Form

Registration: Puppy Training Classes (06-09-2016 - 12-31-2017 )

Thank you for registering for our puppy training classes. Please remember this class is for puppies 8-19 weeks of age at the start of class.

USER INFORMATION
Discount Code:
First Name:
Last Name:
Phone (Day):
Phone (Evening):
Preferred Contact:
Address:
City:
State:
ZIP:
Contact Email:
Pet Name:
Pet Age:
Requirements:
My puppy will be 8-19 weeks of age at the start of class
Pet Breed/Mix:
Gender:
Altered:
How long have you owned your pet?:
Any food allergies?:
Your pet must be up to date on the following vaccinations. Please check all that your pet is current on. :
Bordetella
Distemper
Rabies (if age appropriate)
Your pet must have a negative fecal test dated in the last 6 months. Has one been completed?:
Yes
No
Monday Session:
September 11 - October 16
October 30 - December 4
Thursday Session:
August 10 - September 14
September 28 - November 2
November 30 - January 4
I understand that Puppy and Dog Training class fees are nonrefundable. I certify that my pet is current on his or her vaccinations for Bordetella, Rabies, and Distemper, and is currently on a flea prevention program. I also certify that to the best of my knowledge my dog is free of parasites, internal and external, and free of communicable diseases. I agree to NOT BRING my dog to the building or grounds of Dane County Humane Society if I know or suspect that my dog is ill. If my dog is too young to have been given all of these vaccinations, they will be administered at the appropriate age. I will keep my dog current on all such vaccinations, titers or other vaccine-related recommendations made for my dog by my veterinarian, while attending Dane County Humane Society’s classes. I understand that being around dogs and participating in activities at Dane County Humane Society involves risk of injury to my dog and me. In consideration for being allowed to participate in classes and other dog training activities, I accept these risks. I accept full responsibility for the acts of myself, my dog, and my guests while attending these classes. I understand that Dane County Humane Society cannot be held responsible for any injury caused by me or my dog, or to me or my dog, and I release Dane County Humane Society, its employees, members, and volunteers from all claims of liability, for injury, disease or damage that I, my guests, or my dog may suffer or cause while on the grounds of Dane County Humane Society. I also agree that Dane County Humane Society may photograph or video my participation in any of the dog or puppy training classes and I hereby release any such photographs and/or videos to Dane County Humane Society for its use in programs, publications and other purposes.
Signed:
Yes
Date:
Name:
How did you hear about this event?: