Please understand, this form is not saved or submitted unless you pay for your training. Registration Has This Dog Been Registered In A Class This Year?*YesNoPick Your First Class:*Great Start Puppy Class - Tuesdays 6:15pm - Begin any WeekSerious Self-Control - Wednedays @ 5:00pm - Begin August 5Serious Self-Control - Thursdays @ 6:15pm - Begin August 6Serious Self-Control - Tuesdays @ 7:30pm - Begin August 18Adventure-Ready Dog 1 - Thursdays 7:20pm - Begin any weekAdventure-Ready Dog 2 - Wednesdays 6:15pm - Begin any weekField TripsChanging Emotions Level 1 – 6 consecutively scheduled classes – $275 – August 7 @ 6:00pmChanging Emotions Level 2 – 6 consecutively scheduled classes – $275 – starts June 25 @ 9:00amA private training appointment - $906 private appointments - $5799 private appointments - $86412 private appointments - $1149Please pick the amount you will pay:*Pay for 10 weeks of class get 11 classes - 13 Week Expiration period - $258Pay for 15 weeks of class get 17 classes - 21 Week Expiration period - $3875 Consecutively scheduled classes - 5 Week Expiration period - $129Indicate the date you wish to have your first class:* MM DD YYYY Please pick your start date wisely. This can not change once you enroll.Indicate the field trip date(s) you wish to attend*Please list the date and times of the Private appointments you wish to reserve.*Please pick the dates and times carefully. Once your appointments are reserved switching them usually is not possible.Where do you want your private appointments to take place.* At The Well-Mannered Dog At your house Online Please note, training that takes place at your house will have a travel charge which needs to be paid at your first appointment.Your InformationName of the PRIMARY ADULT who will do the training* First Last Name of other Adults who will attend with youStreet Address Of the Primary person training:* Street Address City State / Province / Region ZIP / Postal Code Email Address of the Primary Person training* Phone Number of primary person training:*Note any changes to your contact information hereYour Dog's Information* Your Dog's Name Birth Date Primary Breed Secondary Breed Sexual Status (ex. intact female) What Local Veterinary office are you presently using?:*What skills does this dog need help with:* Not Jumping on People House training Playful biting Chewing stuff up Leash walking Paying Attention Sit, Down, stand, Stay Come Drop Go to mat Crate training Not guarding food or toys Excessive barking or whining Fear or unfriendly behavior towards dogs or people Distractions Excitability Impulse Control If I could wave a magic wand and fix 1 thing right now, what would that be?*Note here if your dog's has been spayed or neutered or any behavioral changes since your last enrollmentMisc But Important InformationDoes your dog get car sick*YesNoWith the use of treats or chews, will your dog bark or whine repeatedly:*YesNoHow does your dog respond to seeing other dogs? (check all that apply):* Friendly - goes up and sniffs - no stiff body language Friendly - Tries to play immediately Cautious - Stands back, makes Friends after a minute Unsure - Your dog's body goes up but body is stiff Fearful - Barks more than a minute Fearful - Hides Upset - growls, lunges, bites, snarls or snaps Aroused - Hair on the back goes up How does your dog respond to seeing New People? (check all that apply):* Friendly - seeks attention, wiggly Friendly - Jumps on them Cautious - Stands back, makes Friends after a minute Fearful - Barks more than a minute Fearful - Hides, Trembles Fearful - Tucks its tail Upset - growls, lunges, bites, snarls or snaps Aroused - Hair on the back goes up Has your dog every snapped at or bit (in an unfriendly way) a Dog?:*YesNoHas your dog every snapped at or bit (in an unfriendly way) a Person?:*YesNoWill your dog have trouble walking down stairs if it can't be carried?:*YesNoWill your dog have trouble relaxing enough to eat treats?:*YesNoDue Date for next set of vaccines (Distemper / Parvo):* MM DD YYYY Is your dog free of intestinal parasites and other contagious disease?:*YesNoIs 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 made your decide to get professional help?*What attracted you to enroll with us compared to other places you looked at:*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:*YesNoCan you walk down a flight of stairs:*YesNoDo you and your dog quality for this class?:*YesNoDo you agree to all our policies and waiver?:*YesNoCAPTCHA
