IF YOU HAVE A PROBLEM WITH THIS REGISTRATION FORM, PLEASE CONTACT US.

WE HAVE MOVED OUR SITE TO ANOTHER SERVER AND ARE WORKING OUT SOME SMALL PROBLEMS

Today's Date               * Denotes required info

Select type of training:* Select Class Group basic obedience course Monday June 4th @ 8 - 9pm Group puppy course Monday June 4th @ 7 - 8pm Group puppy course Saturday May 26th @ 9 - 10am Group basic obedience course Saturday May 19th @ 10 - 11am Group Intermediate / Advanced obedience course Sunday June 3rd @ 730pm - 830pm Private in home lesson Private lesson at our location Telephone Consultation    

 Brief explanation for behavioral problem

Owners Name *

Address  *  City *

State     Zip Code  * 

Home phone # * Cell Phone #  Work phone #

Email Address *

Dog’s Name *   Breed  

Date of Birth  *  *Male  Female  Spayed/Neutered

Are your dogs shots up to date?  *Yes  No  Has your dog bitten anyone?  Yes  No

If yes, Explain 

Is your dog social with people? * Yes  No  Other dogs? * Yes  No

Primary veterinarian name & address  *

Has you dog been sick recently?  *Yes No  If yes, explain 

When did you get your dog? *  

Where did you get your dog?

Do you Have other dogs, how many?    Cats? 

Do you have children in the home? ages? 

Does your dog know the following commands?  Sit  Down  Stay  Heel  Come

Off  Stand  No  Leave it  Other

Is your dog crated when home alone?: Yes  No

-----------------------------------------------------------------------------------------------

Use box below for telephone consultation info and appointment time

-----------------------------------------------------------------------------------------------

How did you hear about us? * Select One Facebook ad Yellow Pages Newspaper Search Engine Friend Referral Vet Referral Direct Mail Another Website

*******Please Make Checks payable to Mark Renick*******

I understand that whenever my dog(s) and/or I are at Connecticut Canine Training & Behavioral Services or other location used by CCTBS for the purpose of attending or observing training sessions offered by Connecticut Canine Training & Behavioral Services, or for any other purpose, we will be in contact with other people and other dogs, and there is an inherent risk of (a) injury to persons and/or pets and (b) damage to property.  I understand that while participating in training sessions offered by Connecticut Canine, my dog(s) and I will be in contact with other people and with dogs whose temperaments are not known to me or to Connecticut Canine Training & Behavioral Services and whose behavior is not predictable.  I agree that I shall not hold liable Connecticut Canine Training & Behavioral Services, its employees, agents or assigns, whether paid or unpaid, for any injury or damage which results from the training or behavior of my dog(s) or from the training or behavior of another person's dog(s). You are responsible for your dog! No refunds for training services (group or private lessons)
Once you have registered or made an appointment for any of our services, you have agreed to a contract for our services. You will be billed for services that you have contracted for whether you have withdrawn from a class or private lesson. Sorry but due to a few individuals signing up and canceling without enough notice to refill their spot, We have instituted this policy
 

I have read & agree to all the terms & conditions listed above and on ConnecticutK9.com.

*Yes  No

Signature of Owner  *        Date 

When you click the submit button below, you will be forwarded to the course confirmation page. You will NOT receive another confirmation by email, This is your confirmation that you are registered for the class.