Registration Form

Registration Form

Please fill in the form below
Registering for - name and start date of class
e.g. Basic Manners January 10
Your Name
Dog's Name
Dog's Age
Dog's Breed
Phone Number

Area CodePhone Number
E-mail
How did you hear about us? (please be specific so we can thank the person)
Would you like to receive our newsletter?

Yes
I acknowledge the above and agree to continue with the class.
Release From For Photos

Please be advised that you and your dog may be photographed or videotaped during classes or Shake-a-Paw Events. Pictures may be used on Facebook, our webpage, or other promotional material.
Yes, you may use my photosNo, please do not use my photos
DayMonthYear
Should be Empty: