THE NORTHERN NEW JERSEY GERMAN SHEPHERD DOG CLUB
TRAINING REGISTRATION FORM
Name of Handler ( at least 16 yr. old) / Owner :____________________________________________
Address: ___________________________________________________________
Contact Number : Home _________________ Business _________________Cell____________
Email Address _________________Contact Preference__________________
Name of Dog : ____________________________________Breed _________________
Sex : M/F Age (3 Mon. or older) ___________ Spay/Neuter Y/N Dog / People Friendly (circle)
Please state if there are any problems with this dog that concern you ______________
_____________________________________________________________________
CHOICE OF CLASS : Puppy-_____Beginner _____ Intermediate Novice _____Advanced ______
Are you interested in: Basic Obedience __ Competitive Obedience __ Canine Good Citizen Course __
Please tell us what you expect from the class ____________________________________________
Name of Breeder : ________________________Rescue Organization__________________________
AKC Registration Number : ___________________________
Veterinarian Name : _________________________Phone___________________________________
Proof of Rabies Submitted Y/N
Current on Vaccinations (Parvo,Distemper,Hepatitis,Leptospirosis,Bordetella Y/N
Is this your first dog? Y/N In Your Household : Dogs: ____Cats : ___Children/Age______________ Have you trained before ? _____________
How did you hear about us ? Newspaper Name :_________Internet :Y/N Referred by_____________
ARE YOU A MEMBER of this Club? Y/N If not, would you be interested in becoming a member of The Northern New Jersey German Shepherd Dog Club - for GSD Only ________
Would you volunteer on a committee? Y/N What Interests you :
Training the German Shepherd or an All Breed includes participation in "hands on" training, with attendance at orientation/education/discussions. This is an integral aspect of obedience training, and is considered part of the Trainees application.
By signing below, you agree and consent that your dog / handler / owner, may be removed from class at any time in the event that, in the trainer/obedience coordinator sole discretion, your dog / handler/owner creates a safety issue for any other dog / handler / owner, or other animal or individual.
You certify that the above information is correct, and accept full responsibility / liability for your dog.
Print Name : _____________________________________
Signature : __________________________________Date_____________________
Simply print the form and bring with you to the next registration class. See "Classes and Lectures