Class Selection - Welcome to My Puppy Nanny!

First Name:*

Last Name:*

Zip:

Email Address:

Day Phone:

Evening Phone:

Dogs Name:

Dogs Gender:

Dogs Age:

Vet's (or Clinic's) Name:

Dogs Breed:

Vet Phone Number:

Class Selection*

Price: $0.00

Option

Agility 5 weeks
911 5 weeks
Pet therapy 6weeks
Pet therapy seminar 1day
Pet therapy audit
Reliabe recall level 1 5weeks
Reliable recall level 2 5weeks

By submitting the above form containing the information I/we have supplied, I/we agree that as consideration for use and enjoyment of the class and facilities, I/we hereby release My Puppy Nanny, Annemarie Kaighin, Puppy Manners, Donna Bjorklund, class instructors, employees and volunteers, including those owning or working for the physical facility where classes are conducted (all collectively known as "instructors"), from any claims of damage or liability including but not limited to attorneys' fees, arising from the acts or omissions of the instructors, from operation of the class or facility, or which may arise or be caused by any other attending/participating individual or animal as may be present/participating at the facility or in a class.

I agree to the terms:*

I agree

Total

$0.00