Agility Unleashed

Agility Class Application
http://www.agilityunleashed.com

Please arrive at least 15 minutes early on the first night for check-in. All dogs must be current on Rabies and DHLP&P. Bordetella is recommended but not required.

Please take a moment to fill out the information below and return with your check, attached profile form/record of vaccination and proof of obedience training (i.e. Obedience title, training certificate or equivalent).

Salutation First Middle Last
Name:
Phone: Address:
City State Zip
Dog's name: Breed(s): Age: Sex:
List titles earned by dog:
How often will the dog come when called? 100% 75% 50% 25% 0%
Has the dog had prior agility training?:
Obedience training?:

How would you describe the dog's personality? (Check all that apply)

Shy Friendly Fearful Happy
Aggressive Playful Nervous Bored
Hyperactive Loud Annoying Calm
Jealous Submissive Territorial Finicky
Indifferent Dominant Extroverted Dependent

Has the dog ever bitten anyone? If so, please describe when this happened and the circumstances:.

Has the dog ever been in a fight with another dog? If so, please describe what happened:

Record of Vaccinations

Name of Dog owner: Dog's Name:

If applying for membership, answer the following questions:

Please check all that apply:?
DHLP Date Given:
Parvo Date Given:
Rabies Date Given: tag#:
Coronavirus Date Given:
Bordetella Date Given:

 

Name of Veterinary Clinic: ______________________________________________
 

Veterinarian's Signature: _________________________________________________

 

FMI or directions to training facility send email to Ane Gardner at: abbyhobbes@yahoo.com