Obedience Class Registration Form
                                                         Pre-Registration Required

                         $30 deposit or complete $90 fee payable to Sandra W. Ling
                                         7411 Chapel Road, Madison, Ohio, 44057

Owner Name:_________________________________________________

Address:_____________________________________________________

Home/Cell Phone:____________________Email:_____________________

Dog Name:_______________Breed:_______________Neutered?________

Dog’s Age: ___________     How long have you had your dog?__________

Has he growled/bitten anyone?_____Explain_________________________

Dog problems at home?__________________________________________

Veterinarian?__________________________________________________

Do you or your dog have any disabilities or medical conditions that may affect your training?
____________________________________________

I understand attendance at a dog obedience class is not without risk to myself, members of my family, guests or
my dog as some dogs may be unpredictable, even when handled with the greatest of care.  I hereby waive and
release Suburban Dog Training LLC and Sandra W. Ling, employees, volunteers or agents from any liability for
injury or damage that I, my family/guests, or my dog may suffer, and I assume the risk of such damage caused by
myself, family/guests or my dog.

Signed:___________________________________________Date:_______

Office Use:  Puppy____Basic____Adv.Ob.____CGC____Other_____
Form of payment:  Deposit__________Chk.#_________Cash_______
Balance Due_________R’cd.Chk#_______Cash______Date______