TO RESERVE SPACE, PLEASE MAIL BACK THIS FORM AND A MINIMUM

$25.00 DEPOSIT. FULL PAYMENT IS DUE ON FIRST DAY OF CLASS.

younghaus1@yahoo.com

Name__________________________Phone__________Cell________Work__________

Address____________________________City___________State______Zip__________

Pet’s Name___________________Age_____Breed____________Sex____Color_______

Veterinarian______________Last Inoculations________Flea & Tick Preventative______

Puppy Obedience                     5                 February    1:00-1:30                     $100.00

(Bring shot record and hot dog pieces. Do not feed pup 8 hours prior to class.)

Basic Obedience                        5              February     2:00-2:30                 $125.00

Long line Class                           5             February   11:00-11:30                $150.00

Advance Obedience                    7                              12:00-12:30             $150.00

Liability Clause:

I hereby agree to hold Alpha K-9 Training, their owners, directors, trainers, employees

and representatives harmless from any and all liability for any loss, damage or injury to any

person, animal, or anything that may have arisen out of or in any way connected with

participation in training and/or kenneling by Alpha K-9 Training,

Furthermore, I assume all responsibility for any loss, damage or injury to myself, my

animal(s) or my property which may be caused by neglect or any act by any person

connected in any way with the above said training or kenneling.

I herby certify that my animal that I enter in training and/or kenneling will have

received flea & Tick prevention and are up to date on shots against canine distemper,

leptospirosis, parvovirus and canine viral hepatitis, appropriate for age, by the time of their

first training and/or kenneling.

I hereby give Alpha K-9 Training authority to take my animal to a veterinarian while

my animal is being boarded here if they deem necessary to do so and I have made

arrangements to be responsible for any and all costs for such veterinary services while my

animal is in their training/kenneling care. My animal is currently treated for fleas and ticks

and Alpha K-9 Training is not responsible for infestations.

This contract also applies to any future training and/or boarding of animals I bring to

any facility utilized by Alpha K-9 Training.

OWNER HEREBY ACKNOWLEDGES HAVING READ AND UNDERSTANDS THIS CONTRACT:

OWNER______________________________________DATE_________________________