YOU MUST PRE-REGISTER TO GUARANTEE A PLACE IN THE CLASS. CLASS SIZE IS LIMITED. PLEASE MAIL PAYMENT AND COPY OF SHOT RECORD TO:
Hideaway Farm Canine Academy
6680 Salem Rd.
Lakeland TN 38002

Date: ________________________

Class:________________________

Registering for class beginning:____________________

Owner's name: ___________________________________________________

Owner's Address: ___________________________________________________

Phone number: _________________________

Email address: ___________________________________________________

Breed of dog: __________________________

Dog's name: ___________________________________________________

Dog's Age: _____________

Type of Class: Beginner Obedience Puppy Obedience Beginner Agility

Previous obedience training by owner? Yes No
If yes, where:

How many other dogs in your household? _____________

Name of veterinarian: ___________________________________________________

FOR EVERYONE'S PROTECTION IT IS IMPERATIVE THAT ALL DOGS WHO ATTEND CLASS ARE FULLY VACCINATED BY THEIR VETERINARIAN. ALL OWNERS MUST BE ABLE TO SUPPLY EITHER A SHOT RECORD OR A LETTER FROM THE VETERINARIAN SHOWING FULL VACCINATIONS: DHLP, PARVO, CORONA, BORDETELLA, RABIES.

Please indicate any problems you are currently experiencing with your dog:

How did you hear about Hideaway Farm Canine Academy?

What do you hope to accomplish with your dog by obedience/agility training?