GOLDEN RULE SCHOOL FOR DOGS
ENROLLMENT FORM

Name:____________________________________________________________________
Address:__________________________________________________________________
City,State,Zip:______________________________________________________________
Telephone #: Home (______) _______-_____________
                     Work  (______) _______-_____________
Dog's  Name:____________________________________________
Dog's  Breed:_______________________________________      Color:___________________
Dog's Age:___________
Class(es):________________________________________________________________________________
Check One:     Daytime Session:__________     Evening Session:__________
How did you hear about Golden  Rule?_________________________________________________________
Number of people attending  orientation:________  Amount enclosed: $________


Send check payable to Golden Rule School for Dogs,  LLC to address above
I attest that my dog has had  the following vaccinations on the dates stated:
(Please attach a  xerox copy of your dog's vet records)

Distemper:  ____/____/____  Parvo: ____/____/____  Parainfluenza:  ____/____/____  Rabies*: ____/____/____                    

*Puppies under 6 months of age are exempt from the rabies requirement
 

I understand that attendance at a dog  training facility is not without risk to myself, members of my family or  guests who may attend, or my dog.  I hereby waive and release Golden  Rule School for Dogs, LLC, its instructors or agents from all liability of  any nature resulting from the actions of any dog while on or in the training  grounds or surrounding area.

Signature  ___________________________________________________________________


The instructor reserves the right to excuse any dog that persists to be vicious in nature.