Copy of Copy of Copy of Behavior Class Reg Form

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CDL2Class Registration Form

NAME OF CLASS

STARTING DATE

YYYY

Receipt # (if already paid)

Name

Email (for confirmation letter)

Phone Number:

How did you learn about us?:

Dog's name:

Breed

Age when class starts

Yes

Where have you graduated from a Companion Dog Level 1 or a class that is Equivalent?

Please describe how your dog acts around other dogs, strangers and new situations:

This class is designed for dogs that have graduated from a beginner or intermediate group course at PHS/SPCA or another training facility. Where did you take classes?

What are your goals for your dog?

Upload Vaccine Records

Please upload a copy or photo of your dog's most recent vaccination records: DHPP, Rabies (if over 6 months) & Bordatella (recommended). You can alternatively email records to training@phs-spca.org

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Class Waiver
I agree to indemnify, defend and save harmless the Peninsula Humane Society & SPCA), its officers, agents and employees from and against all loses and claims, demands, payments, suits, actions, recoveries and judgments of every nature and description brought or recovered against PHS/SPCA by reason of any act or omission of myself, my child, or my dog in the execution of the dog training course. I fully understand the risk present in a dog training instruction course and freely and voluntarily assume those risks and further agree to save harmless and release PHS/SPCA, their officers, agents, and employees from and against all claims for injury, loss or damage to me, my child, my dog or other property as a result of such course. I further understand and accept that refunds will only be given for cancellations made at least 72 hours before the first class. No credit given toward future classes for incompletes or failure to cancel. No make-ups for missed classes; we will, however, provide homework sheets for missed classes. Participants must complete four of six classes to graduate to the next level. By entering your name in the box below, you are agreeing to the terms and conditions of the above waiver.

Agree to the above waiver by entering your digital signature (use mouse to sign):