Training Enrollment Please fill out the following information to start your training: Name* First Last Email* Phone*Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Pet's Name, Breed, Age*Training Goals*Problem Areas*Have you trained with another company? If so, who?*Veterinarian Information (we will call to verify vaccines)*Which training services are you interested in?* Private Instruction Group Obedience Puppy Class Socialization Canine Good Citizen Rally or Agility Do you have multiple dogs?* Yes No Are you a current Peachtreee Pets customer?* Yes No I understand that dog training may involve risk to myself, members of my family, or my dog. I assume all risks associated with participating in a training class and will not hold Peachtree Pets or its instructors responsible in the event of injury to myself, family members or my dog. I agree to comply with the instructions, rules, and decisions of the training instructor as it relates to me or my dog's ability to safely complete a course. I also agree to assume all responsibility for any damage done to property, persons, or other dogs done by me or my dog's actions. There will be no refund after completion of the first class and understand that there are no regularly scheduled make up sessions if I miss a class session. I understand that all dogs participating in the training classes of Peachtree Pets must be free of any infectious disease and must be current on all appropriate vaccinations, including bordetella, canine influenza, distemper, parvovirus and rabies. I also understand that all dogs enrolled in the training class must be receiving monthly preventative treatments for the control of fleas. I understand that Peachtree Pets does not guarantee the results of its canine training classes. I grant permission to Peachtree Pets to use owners and pets images or video taken during training sessions for educational and promotional purposes. I hereby agree and covenant for myself, my heirs, executors, administrators and anyone else who may claim on my behalf to waive, release and discharge Peachtree Pets and it's employees or contractors from any and all claims arising out of or in connection to with or in any way related to this training class.Signature* Δ
