Training
Register/ Request On-Line:

Canines Unlimited - 907-790-DOGS

Also See:
Training Philosophy
Class
Registration Info & Form
Credentials

Finishing the tunnelFlyball is gret fun!Homemade gourmet dog mealsConfidence course/agility prepJenny on an outing at the Shrine

Registration Request Form

E-Mail:
Owner/Handler Name:
Billing Address:
City:
State: Zip:

Home Phone:

 

Work:

Cell:

1. Dog's Name:
2. Dog's Gender:
Male Female   
3. Dog's Age:
Years Months  
4. Dog Spayed/Neutered:
Yes No   
5. Dog's Breed (If mixed choose dominant breed):
  
6. Dog Acquired From:
  
7. Veterinarian:
8a. Class or Service Requested
8b. List 2-3 preferred class sections, in Priority order  
9a. Add Bonus Bag of Equipment? Yes No(Additional cost)
9b. Add 20' Longline only? Yes No(Additional cost)
10. What training and/or behavior modification have you done so far with this dog? In what class or with what trainer and where?  
 
11. List Family Members Your Dog Lives With or Sees Regularly (If children, list ages; also include other pets):
1.      2.     
3.
4.      5.     
6.
12. Your Training Experience:
13. Dog's Personality:
(choose as many as apply)
Friendly to people
Friendly to other dogs
Overly shy around people
Overly shy around other dogs
Nervous around people
Nervous around other dogs
Aggressive towards people
Aggressive towards other dogs
Jumps on people
Uses mouth to play
Barks frequently
Snaps or bites
14. Dog's Environment:
(choose as many as apply)

Lives in house
Not allowed in house
Has fenced yard or run
Allowed to run free
Other dogs in family
Only dog in household

15. What are your goals for you and your dog?
16. What do you like about your dog?
17. What is not so good about your dog?
18. How does your dog spend his/her day?
19. How did you learn of these classes:
20. What date will you be starting in the group class at 9447 LaPerouse?  
21. (FLEXIBLE PuppyK/ Basic Obedience only) Prior to your first Friday class, what are several day/date/times that would work well for you to do your Quick Start individual lesson and orientation at our shop, 4191 Taku Blvd.? (We will contact you to schedule this lesson.)
22. List vaccinations/titers and current expiration dates: Rabies (required if 6 months or older), Bordatella (not required), and Distemper combo. You must have written documentation of the above vaccinations and are certifying that you can produce it at any time.  
23. List special problems, considerations or needs for your dog, especially dog or people reactiveness or aggression:

24. Release:

I register the dog named above and release Canines Unlimited, Martha Fischbach, Shotokan Karate Club, other instructors and any other associated entity from all liability for damages or injuries of any nature that may arise in connection with training classes.
I certify this dog has had puppy vaccinations and age appropriate vaccinations, and is immunized appropriately for health and safety, is in healthy condition, and is not a danger to other animals or humans. I certify I have and can produce written documentation of all vaccination information.
Canines Unlimited has permission to use, and retains all rights to use any of my comments, any photos, or audio/video materials made for educational, informational, promotional or commercial purposes, such materials becoming the property of Canines Unlimited/Martha Fischbach.. I understand there are no credits, transfers or refunds.
Training classes: Classes are to be completed within the course time frame for which registered. Classes may be added, combined, canceled or changed, subject to enrollment. Due to the flexible nature of class and enrollments, I understand the importance of being on time to assure my place in class, no reservations. Additional sections will be added if classes are regularly over attended.
I have read, understood and agree with the class information, policies and fee structure, I agree to do my homework, agree to the payment schedule for which registered, and request signup for the E-newsletter. I promise to immediately contact Canines Unlimited/Martha Fischbach with any questions, comments, or concerns I have about class. These policies may be revised/changed at any time, without notice.

Yes, I agree (must check box)

 

 


Copyright 1998-present Canines Unlimited, All Rights Reserved
Canines Unlimited
Martha Fischbach, Owner
4191 Taku Blvd. Juneau, AK (shop location)

P.O. Box 34496, Juneau, Alaska 99803

Phone: 907-790-3647; Fax: 907-789-9663
E-mail: info@caninesunlimited.com