Untitled Document

	Please print this sheet. Fill out the information and bring it with you to your first night of class.

	Registration Form

	Class:____________________________________________________________ Name:____________________________________________________________ Address:__________________________________________________________ City:_____________________________ State:________ Zip:_______________ Telephone Number: (______)_________-________________ Call Name of Dog:________________________________________________ Breed of Dog:____________________________________________________

		I, the undersigned, do certify that I will hold harmless Excel Dog Training, Inc. and all persons connected there within, in any capacity whatsoever, from and all liability, cost and expense for any injury or damage to persons or property caused by any dog brought by me to training classes now, or in the future, or to any other events held or sponsored by the corporation.

Today's Date: _______________ Signed:__________________________ Date of Rabies: ______________ Signed:__________________________
			(Parent/Gardian if under 18 years of age)

Membership in training will be granted on a first come, first serve basis. There are no refunds given. The corporation reserves all final decisions on all applications.
Make all checks payable to: Excel Dog Training, Inc. * No Credit Cards Accepted.*
................................................................................ (Office Use Only) Pre-Registered: ________________ Check Number:__________ Cash: _________________ Leash Number:_________________ Cost: $________________ Tax:___________________ Collar Number:_________________ Cost: $________________ Tax:___________________ Other:________________________ Cost: $________________ Tax:___________________ Total $ Paid: ____________________