About YouName* First Last Address* Street Address Address Line 2 City ZIP / Postal Code LandlineCell*Email* Is This Your First Puppy?* Yes No Where Did you Hear About the Club?* Your Vet Breeder Web Club Member Other Your Vets Name Other (Please Specify) What Made You Choose Our Club?* About Your PuppyDogs Name* Breed* Date of Birth* Day Month Year Gender* Male Female How Old Was Your Puppy When You Got Him/Her?* Do You Have Any Problems With Your Puppy?* Yes No Please Describe Any Problems You Are HavingDo You Have Other Dogs?* Yes No Your Other Dogs Please list your other dogs separated by commas Select a Class* Puppy 1 for new pups under 4 months Puppy 2 for pups who have completed Puppy 1 Junior Puppy Obedience for pups who have completed Puppy 2 Senior Puppy Obedience for pups who have completed Juniors Select the Appropriate Fee* Full (R400 per course) Senior Citizen (R200 per course) Terms & Conditions I understand that all training is at my own risk and that the Cape Province Dog Club and Pinelands Primary School are in no way liable for any injuries sustained by either my dog or myself in the course of training. I guarantee that my dog is properly immunized. I further understand that I may be held responsible for any damage caused by my dog or myself. I agree to conduct myself in a responsible manner and to follow instructions given by trainers.Accept Terms & Conditions* Accept By selecting or checking this box, you have read and agree to the terms and conditions stated above.