Has this dog, been registered in one of our classes this year? Has this dog, been registered in one of our classes this year? Yes No

Pick Your Class Pick Your Class Great Start Puppy Class - Tuesdays 6:15pm Serious Self-Control Class - Tuesdays 7:30pm Adventure Ready Dog 1 Class - Thursdays 7:20pm Adventure Ready Dog 2 Class - Wednesdays 6:15pm Games and Sports Class - Wednesdays 7:15pm Changing Emotions Level 1 – 6 consecutively scheduled classes – $275 – June 6 @ 2:30pm Changing Emotions Level 2 – 6 consecutively scheduled classes – $275 – starts June 6 @ 9:00am A private training appointment - $90 6 private appointments - $540 12 private appointments - $1080

Please pick the amount you will pay Please pick the amount you will pay 5 Consecutively scheduled classes for $129 Pay for 10 weeks of class get 11 classes $258 Pay for 15 weeks of class get 17 classes - $387

Indicate the date you wish to have your first class

Please list the appointments times we discussed over the phone

FIRST & LAST Name of the PRIMARY Adult who will do the training

Street Address Of the Primary person training

City

State

Zip code

e-mail address of the primary person training

Phone Number of primary person training

Name of other people who will attend with you

Your Dog's Name

Your Dog's Primary Breed

Your Dog's secondary Breed

Dog's Date of Birth (or approximate)

Your Dog's Sex Your Dog's Sex Neutered Male Intact Male Spayed Female Intact Female

What Local Veterinary office are you presently using?

What skills does this dog need help with What skills does this dog need help with Greeting without jumping House training Playful biting Chewing stuff up Leash walking Paying Attention Sit, Down, stand, Stay Come when called Drop it To leave things alone Go to mat Crate training Not guarding food or toys Excessive barking or whining Unfriendly behavior towards dogs or people Distractions Excitability Impulse Control

If I could wave a magic wand and fix 1 of your dog's behaviors right now, what would that be

Does your dog get car sick Does your dog get car sick Yes No

With the use of treats or chews, will your dog bark or whine repeatedly With the use of treats or chews, will your dog bark or whine repeatedly Yes No

How does your dog respond to seeing other dogs? (check all that apply) How does your dog respond to seeing other dogs? (check all that apply) Looks at them and stays by you Ignores them Whines and pulls towards them Barks and Lunges towards them Hair on the back goes up Tucks its tail Raises its lip Shakes Hides or runs away

How does your dog respond to meeting new people? (check all that apply) How does your dog respond to meeting new people? (check all that apply) Looks at them and stays by you Ignores them Whines and pulls towards them Barks and Lunges towards them Hair on the back goes up Tucks its tail Raises its lip Shakes Hides or runs away

Has your dog every snapped at or bit (in an unfriendly way) a person or dog? Has your dog every snapped at or bit (in an unfriendly way) a person or dog? Yes No

Will your dog have trouble walking down stairs if it can't be carried? Will your dog have trouble walking down stairs if it can't be carried? Yes No

Will your dog have trouble relaxing enough to eat treats? Will your dog have trouble relaxing enough to eat treats? Yes No

Is your dog free of intestinal parasites and other contagious disease? Is your dog free of intestinal parasites and other contagious disease? Yes No

Can you provide proof your dog is up to date on vaccines with either, 1. positive titer results or 2. a current vaccination certificate. Can you provide proof your dog is up to date on vaccines with either, 1. positive titer results or 2. a current vaccination certificate. Yes No

Is there any additional information about your dog you would like me to know?

How did you find out about our training?

What other local training have you attended

What gave you confidence to sign up for our training?

What attracted you to enroll with us compared to other places you looked at

Are you interested in any dog sports? Are you interested in any dog sports? Musical Freestyle Tricks Agility Nosework Canine Good Citizen Rally Fre Parkour Flyball Conformation Competition Obedience None

Can you hear instructions even if your instructor is 30 feet away Can you hear instructions even if your instructor is 30 feet away Yes No

Can you walk down a flight of stairs Can you walk down a flight of stairs Yes No

Do you and your dog quality for this class? Do you and your dog quality for this class? Yes NO

Do you agree to all our policies and waiver? Do you agree to all our policies and waiver? Yes No