Headwaters Dog Training Class Registration

Please fill out all fields below to confirm a spot in the class. Email [email protected] with any questions!

* Indicates required field

Name *

Phone Number *

Are you okay with receiving text messages at this number for class notices? *

Yes No

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Dog’s Name *

Dog’s Age *

Dog’s Breed and/or Size *

What are your main training goals for your dog? *

Does your dog have any history of aggression or reactivity? If so, please explain below. *

Yes No

If checked yes above, please use this box to elaborate. *

Is your dog up to date on Rabies and DPP (Distemper/Parvo/Parainfluenza) vaccines as appropriate for their age? *

Yes No

By typing my full name in the text box below, I acknowledge that my dog’s participation in the class will be contingent on paying the $90 ($15/per one-hour class for six classes) and signing a liability waiver that will be provided after registration but before the first class starts. I also agree to follow class policies as set by the trainer to keep every member of the class safe and having a good experience. *

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