Shadowland Kennels Beginner Obedience Class Registration
Print and return to Shadowland Kennels-2501 Galeston Ave. Oskaloosa, Ia.
52577 or return by email to
runjumpwag@live.com
Remember, the first night we will all meet together at 7:00 without our dogs.
Classes beginning (please write start date here) ____________________
Over 6 mos. _______ Or Puppy class (under 6mos)  _______
Plan to attend Basics Seminar? _____________
Name of Owner or Person Training dog___________________________________________________
Address _______________________________________City_____________________Zip_______
E-mail Address________________________ Occupation________________________________
Home Phone ________________________ Business Phone_____________________________
Call Name of Dog______________________ Breed__________________________ Age______
Sex__________ Spayed/Neutered? ________ Age when Spayed/Neutered___________________
Age Obtained_______ From Where_______________________________________________________
Have you owned a dog before ____________ Breed (s)__________________________________
Have you trained a dog before ____________ When _____________ Where _______________
State briefly any problems that brought you to class:
What do you hope to accomplish?
Do you have any hearing or other physical handicaps?

Does the dog have any physical problems or disabilities that may affect his training?

If your dog has had any illness, parasite or skin disorder in the last 6 months,
state the nature of the problem and whether treated by a veterinarian.
Name of Veterinarian:___________________________________________
Date of last Distemper/parvo virus inoculation:________________________________
Rabies Vaccination No. _____________________Date of Rabies Vaccination__________________
Date of last Fecal Exam (Required) and results:_________________________________________

What kind of dog food do you feed? Please state exact brand, canned, dry, etc.

How did you hear about our classes?

Has your dog ever bitten a person or another dog?
Please Check One: Remember-No Refunds are given so be sure of your commitment to class.
I have enclosed a check for $1
20.00 to pay for the class. __________
I will pay at the 1st class. __________

Do not mark below this line________________________________________________________
WK 1 -----WK 2---- WK 3----- WK 4----- WK 5----- WK 6----- WK 7-----
Waiver
I understand that attendance of a dog obedience training class is not without risk to myself,
members of my family or guests who may attend, or my dog, because some of the dogs to
which I (we) will be exposed may be difficult to control and may be the cause of injury even
when handled with the greatest amount of care.
I hereby waiver and release Shadowland Kennels, its employee, owners and agents from
any and all liability of any nature, for injury or damage which I or my dog may suffer,
including specifically, but not without limitation, any injury or damage resulting from the action
of any dog, and I expressly assume the risk of any such damage or injury while attending any
training session or other function of the School, or while on the training grounds or the
surrounding area thereto.
In consideration of and as inducement to the acceptance of my application for training
membership in the obedience training class, I hereby agree to indemnify and hold harmless
members of my family or any other person accompanying me to any training session of
function of the School or while on the grounds or the surrounding area thereto as a result of
any action by any dog, including my own.
Signature of Owner or Authorized Agent
X________________________________________________
Date X________________________________________________