Handler's name:

Pet's name:

Sex: Male Female Neutered/Spayed? Yes No

Breed: Color:

Date of birth:

Acquired from:

Owner's last name:

Owner's first name:

Address:

City:

State: Zip code:

Home phone: Work:

Email:

Fax:

Program commence date (mm/dd/yyyy):

Program commence time:

I DO HEREBY APPLY TO REGISTER AND/OR TRAIN MY OWN DOG IN THE PROGRAM COMMENCING THE DATE & TIME ABOVE. I ASSUME FULL RESPONSIBILITY FOR THE ACTIONS OF MY DOG WHILE ON THE PREMISES AND RELEASE SHEL-RAY® PET SHALET and its personnel from any and all claims, actions or causes of actions resulting out of or in any connection with the said training program. I understand that all fees become non-refundable. If the handler is under the age of 18, the parent or guardian gives permission and accepts responsibility as indicated. I declare that the above dog is not a hazard to other pets or humans.

The private class included with the In-Residence training must be accomplished within 30 days of picking up the dog or the class will be forfeited and/or additional fees will be required to continue at the discretion of the Director of Training.

A veterinarian certificate will be provided, with dates of required innoculations: DHLPP-RABIES-BORDATELLA. Also, highly recommended is CORONA and LYME. The charge card information below is completed as full payment.

I also understand that I must follow the rules noted both in written and verbal form while on SHEL-RAY® PET SHALET property. I have received a copy of such written rules. SHEL-RAY® PET SHALET has the right to enforce these rules in a manner in order to protect other pets, property or persons by immediate dismissal withut refund.

Please call our office with your credit card information at: (262) 857-2163.