Class Sign Up Form

Please enter the information below to signup for a class with Canine Harmony. Click Here to return to our Main Page

Name * First Last
Address *
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Primary Phone * - (###) - ### ####
Alternate Phone - (###) - ### ####
Email *
Name for Graduation Certificate - Can be one or more names or a family name (eg: Bob and Mary Smith OR Suzy Jones OR The Martin Family etc.) Does not apply for drop in classes.
Dog Information
Dog Name *
Breed or Breed Mix *
Age *
My dog is .. * Male Female
My dog has ... * been spayed or neutered not been spayed or neutered
Vets Office Where Vaccines Were Given *
Date of Bordetella/Kennel Cough Vaccine * / MM / DD YYYY
Date of Parvo/Distemper Combo Vaccine * / MM / DD YYYY
My Dog Is (check all that apply)... * New to Obedience Training Done Some Obedience Training A Pro at Obedience but Needs Practice New to Agility Done Some Agility A Pro at Agility but Needs Practice
I am signing up for .. * Basic Obedience in Langley at Harvey Pet Food Intermediate Obedience in Langley at Harvey Pet Food Drop In Agility Club at Canine Harmony in South Surrey
Other information you would like to include with your registration?
I understand that attendance at a dog obedience training class is not without risk to myself, members of my family or guests who may attend, or my dog, because some of the dogs to which I will be exposed may be difficult to control and may be the cause of injury even when handled with the greatest amount of care.

I hereby waive and release CANINE HARMONY DOG TRAINING ACADEMY hereinafter referred to as the Training Organization, its employees, officers, members, and agents from any and all liability of any nature, for injury or damage which I or my dog may suffer, including specifically, but without limitation, any injury or damage resulting from the action of any dog, and I expressly assume the risk of such damage or injury while attending any training session, or any other function, of the Training Organization, or while on the training grounds or the surrounding area thereto.

In consideration of and as inducement to the acceptance of my application for training membership by this Training Organization, I hereby agree to indemnify and hold harmless this Training Organization, its employees, officers, members, and agents from any and all claims, by any member of my family or any other person accompanying me to any training session or function of the Training Organization, or while on the grounds or the surrounding area thereto as a result of any action by any dog, including my own, as well as any accident which may occur while on the training grounds or surrounding area.
* I have read and understand the waiver above and agree to hold Canine Harmony free of any liability as a result of my participation

Class Sign Up Form

Class Sign Up Form

Dog Information