Please Print Clearly
Owner's Name:_________________________________________
Address: ______________________________________________________________________
City: __________________ State: _________ Zip: ________Phone: hm____________
EMAIL ADDRESS ___________________________________ Wk_________________
Breed: ________________ Pet's Name: ____________________ Age: ______________
Veterinarian: _________________________________ Phone: _____________________
Please check class you wish to attend
Obedience Behavior I ___ II ___ III ___ Tricks and Games Class ____
Behavior Class I ____ II ___ Agility and Games Class ___ I ___ II
Attention ____ Other _____________________________
Starting Date: ___________________ Time: __________________
Referred by: ____________________
What are your expectations of this class? ______________________________________
All classes are $125.00 for an 8-week session. To reserve a place in this class, please print this application and complete it, and mail it with your $125.00 check MADE PAYABLE TO:
15631 Old Brick Yard Road
Shakopee, MN 55379
(952)445-2993
$100.00 refund if cancelled prior to, but greater than one week of start date
$50.00 refund if cancelled with in one week of start date
No Refunds if cancelled on day of, or after first class starts
In signing this release, I/we acknowledge that I/we understand the intent of the services provided by the staff at Unleashed. I/we hereby agree to absolve and hold harmless the staff at Unleashed and any other parties connected with the services being provided in any way, singly or collectively, from and against any blame and liability for any injury, misadventure, harm, loss, inconvenience or damage hereby suffered or sustained as a result of participation in the services or any actions therewith. I/we hereby consent to and permit emergency treatment for illness or injury and assume all financial obligations resulting there from.
Signature: ______________________________________ Date: ___________________
Print Name: _____________________________________________________________
Signature of Parent (if under 18 years of age): __________________________________