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TRAINING REGISTRATION FORM
Information about you
First Name Last Name Street Address City Zip Code Email Home Phone Work Phone Cell Phone
First Name
Last Name
Street Address
City
Zip Code
Email
Home Phone
Work Phone
Cell Phone
Information about your dog
Name Date of Birth (approximate if unknown) Breed Color Gender Choose One female spayed female male neutered male Veterinarian/Clinic Name: Vaccination Dates (proof of vaccinations must be submitted prior to the first class): DHPP Bordetella Rabies Proof that all vaccinations (DHPP, Rabies and Bordetella) are current is required prior to beginning any training class at Doggie Day Care of Fayette. Please have your veterinarian fax your records to us at 678-817-1638 or otherwise furnish them prior to the first class.
Name
Date of Birth (approximate if unknown)
Breed
Color
Gender Choose One female spayed female male neutered male
Veterinarian/Clinic Name:
Vaccination Dates (proof of vaccinations must be submitted prior to the first class): DHPP Bordetella Rabies
Proof that all vaccinations (DHPP, Rabies and Bordetella) are current is required prior to beginning any training class at Doggie Day Care of Fayette. Please have your veterinarian fax your records to us at 678-817-1638 or otherwise furnish them prior to the first class.
Has your dog ever bitten anyone? Yes No If yes, please explain:
Is your dog aggressive toward: People? Not at all Slightly Moderately Severly Other dogs? Not at all Slightly Moderately Severly
Training Selections
Training Class Choose One Intermediate Obedience Puppy Preschool Basic Obedience Foundation Skills/Agility Basic Agility Intermediate Agility Competitive Obedience (Beg.) Rally Competitive Obedience (Utility) Canine Good Citizen Preferred Date (See Training Schedule for list of dates for each class)
Training Class Choose One Intermediate Obedience Puppy Preschool Basic Obedience Foundation Skills/Agility Basic Agility Intermediate Agility Competitive Obedience (Beg.) Rally Competitive Obedience (Utility) Canine Good Citizen
Preferred Date (See Training Schedule for list of dates for each class)
Method of Payment*
Cash Check VISA MasterCard Credit Card Number Credit Card Verification Code (last 3 numbers on signature line) Expiration Date
Cash Check VISA MasterCard
Credit Card Number Credit Card Verification Code (last 3 numbers on signature line) Expiration Date
Credit Card Number
Credit Card Verification Code (last 3 numbers on signature line)
Expiration Date
*A non-refundable deposit of $25 is required at the time of registration. Should you prefer to pay by cash or check, please submit your registration on-line, and either come by our facility to make payment or drop a check in the mail to DDC, 187 N 85 Parkway, Fayetteville, GA 30214. Remember, your registration will not be considered complete until a deposit is received. Should you elect to pay via VISA or MasterCard, please provide your credit card information above. Please note, this is a secure website.