Application for Right Start Training Classes
Paid pre-registration required. Please print this page, fill in the information, and mail (check payable to Michelle Mange ) to the following address:
Right Start Maryland Dog Training
11558 Summer Oak Drive
Germantown, MD
20874
If the class you request has been changed, filled, or canceled, you will be notified immediately.
Please note: Payment and registration form must be received to reserve your spot in a class. If a class has already filled, we will let you know.
Confirmation will be sent via e-mail unless otherwise requested.
Trainer's Name (person taking dog through class):
Street Address:
City, State, ZIP:
Telephone Number(s):
E-mail Address (you will receive email confirmation unless otherwise requested):
Dog's Name: Breed(s):
Date of Birth: Sex: M F Neutered or Spayed? YES NO
Veterinarian's Name and Telephone Number:
Trainer's Previous Class Experience:
Class Requested (circle one): Puppy Preschool ---- Canine Etiquette ---- Canine Etiquette II---Canine Etiquette III ---- Advanced ----
Desired Class Date and Time from Brochure or Web site:
2nd Choice Desired Class Date and Time
Please Tell Us What You Would Like Your Puppy/Dog To Learn:
What Would You Like your dog to Stop Doing?
What Should We Know About Your Puppy/Dog? (e.g., shy, aggressive, afraid of thunderstorms, had recent surgery, other physical trauma, particular likes, dislikes, habits, distinctive behaviors)
How Did You Hear About Us?
I certify that this pup has been immunized for rabies (if 4 months old), distemper, and parvovirus. I agree to hold Right Start Training dog training of Maryland, Michelle Mange, my instructors, teaching assistants, Frederick County Humane Society harmless from any and all liability arising as a result of this activity, including but not limited to injury or death to dogs, bodily injury or death to any person, and damage to property. I have read and agree to abide by the rules and understand that failure to do so can lead to dismissal from classes.
Signature and Date
