Canine Potentials
From
the highway take
The
address is
Carol Gannaway 341-0581
Remember proof of vaccinations!
APPLICATION FOR TRAINING
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Handler Information |
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Name |
How did you learn about these classes? |
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Street |
¨ Former Trainee |
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City |
¨ Veterinarian |
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Zip Code |
¨ Newspaper Ad |
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Phone |
¨ Flyer |
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¨ Other |
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Dog Information |
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Breed |
Age: Sex: ¨ M ¨F Spayed/Neutered: ¨ Y ¨N |
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Name |
Veterinarian |
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Last Vaccination dates: |
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DHLP+P: |
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Bordetella: |
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Rabies: |
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AGREEMENT TO HOLD HARMLESS, WAIVER, AND ASSUMPTION OF RISK I understand that attendance of a dog obedience training class is not without risk to myself, members of my family or guests who may attend, or my dog, because some of the dogs to which I will be exposed may be difficult to control and may be the cause of injury even when handled with the greatest amount of care. I hereby waive and release Canine Potentials and CarolGannaway from any and all liability of any nature, for injury or damage which I or my dog may suffer. I expressly assume the risk of such damage or injury while attending any training sessions. |
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Signature: |
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Date: |
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Please help me with some information about you and your dog:
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How long have you owned this dog? |
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Is this your first dog? |
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Age of dog when you acquired it: |
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Where did you acquire: |
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Why did you choose this dog? |
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How often is your dog excercised? |
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Describe your dog’s behavior |
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around other dogs: |
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guests and strangers: |
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Do you have other dogs at home? |
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How do they all get along? |
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What percent of time does the dog spend: Inside? |
Outside? |
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What percent of time does dog spend in the company
of other dogs? |
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Mark the statement that best describes your thoughts about your dog: |
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Super, the very best. |
q What was I thinking? |
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Pretty good most of the time. |
Other |
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Listed below are a few phrases that describe common dog behaviors
some of them are more desirable than others from the human perspective.
Please check the appropriate box as it relates to your dog. |
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NEVER |
OCCASIONALLY |
OFTEN |
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Reliably comes when called |
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House-trained |
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Likes kids |
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Rides well in the car |
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Chases cars, bikes or people |
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Walks politely on leash |
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Sits on command |
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Gets along with other dogs |
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Lies down on command |
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Jumps up on people |
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Steals food or objects |
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Stops barking when told |
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Plays fetch |
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w objects |
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Protective |
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Accepts grooming/nail clipping |
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Remains at home alone calmly |
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