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HALO Puppy Training Academy Request

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Personal Information

* First name

* Last name

* Email

* Email confirmation

Home phone

Cell number

* Current Address

Current Address 2

* Zip

* City

* GenderMaleFemale

Country

*State/Province

Date of Birth

* Month

* Day

* Year

Pets Information

Pets name

Pets age

Pets breed

Are you an existing HALO client?

YesNo

Class interested in

Puppy Class 1- for dogs 3-4 months oldPuppy Class 2- for dogs 5-11months oldBeginner Dog- for dogs 1yr+

Is your pet spayed or neutered?

YesNo

Please include a copy of your pets vaccine records- vaccines are required for class enrollment

Does your pet have and behavioral or medical issues we should be aware of?

What are you looking to get out of the training class for you and your pet?

Waiver

I understand that all dogs registered in HALO's Puppy Academy classes must have current distemper, hepatitis, and Parvo vaccines and that all dogs over the age of 6 months must have a current rabies vaccine. HALO also recommends but does not require current bordetella vaccination.

YesNo

Waiver

In joining HALO's Puppy Academy obedience classes as a student, I hearby assume all risks and responsibilities for the accidents and damage to my property, others, or myself, that result from the actions of my dog. No member or instructor shall be held liable for injury and or/damage to myself or property, wether due to uncontrolled dogs or negligence of any member or instructor.

YesNo

I have read and agree to the terms and conditions. By checking this box I am confirming that I am 13 years of age or older.

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