| Please complete this registration form to be eligible to attend a class or the dogpark. |
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| Your Name: |
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| Address: |
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| City: |
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| State: |
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| Zip: |
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| Home Phone: |
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| Cell: |
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| Email Address: |
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| Dog's Name: |
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| Dog Breed |
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| Age |
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| Weight |
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| Sex |
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| Altered? |
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| Date of last rabies vaccine |
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| Date of last DHLP vaccine |
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| Date of last Bordetella vaccine |
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| How long have you owned this dog? |
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| Does your dog get along well with |
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| I got my dog from |
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| Shelter Humane Society Breeder Other |
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| What training has your dog had |
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| What else would you like to share about your dog? |
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| Which classes are you interested in? |
Agility Obedience Puppy Obedience Intro Agility
Flyball Schutzhund Open dog play time |
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Do you prefer:
Day Classes Evening Classes Weekend Classes
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| How did you hear about us? |
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DISCLAIMER: I understand and agree that if I am enrolled in a class, or classes, at Rottstars agility fun and training center , that I will not hold Rottstars, my instructors, other students, their dogs, or other dogs in attendance, or children present liable and/or responsible for any harm or damage that may occur to myself, my dog(s) or my property.
By entering your initials in the box below you Agree with and accept the conditions of the above disclaimer
I agree
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