Application for Training Classes for Existing Students

Town & Country Animal Care Center & Training
Training Application for Existing Students

You may fax or mail this form with proof of vaccination required prior to beginning of class.
2010 N. Salem St., Apex, NC 27523 | Fax: 919.363.5077 | Phone:919.387.7833

Please read and check off each of the following before completing the form below:

I have read, completed, and understand the required Town & Country Training Application

I have provided Town & Country with the required proof of vaccination (we accept your personal veterinarian vaccination protocol)

I understand that I am requesting a Training Class, and completing this form does not constitute acceptance into the class without payment

I have read, completed, and understand the required Town & Country Injury Waiver Form (separate form submitted annually)

Owner's Name: ____________________________ Class:___________________

Address: _____________________________________________________

City: _________________________ State: _______ Zip: ______________

Home: ________________ Work: _______________ Cell:______________

Pet's Name: ________________________________________________________

Breed: __________________ Dog's Age: ____________ Dog's Sex: M / F

Color: __________________ Date of Birth: _____________________________

What do you want to accomplish in this class? ___________________________

_____________________________________________________________________________________________________

All dogs handled by a minor must have prior approval from instructor. Child must weigh at least double the dog's weight in order to control dog. Children must be supervised through entire class.

Check your schedule and remit this form, vaccination record and your class choice to Town & Country Animal Care Center.

Your spot in class is not reserved until completed registration form, current vaccine information, and full payment are received.

Payment is NON-REFUNDABLE. Initial:_____________

All checks are made payable to: Town & Country Animal Care Center

We at Town & Country Animal Care Center want to see you and your pet succeed with our training classes. Practice at home is important and will ensure that your pet will be an enjoyable and trusted family companion.

*** I understand that I am solely responsible for myself, my pet, my children, guests, and all personal belongings while on Town & Country Animal Care Center property. ***

Signature: ______________________________________ Date: _______________

Credit Card #: ___________________________________ Expiration Date: ____________

[ ] Please contact me at ____________________________ for payment information.