Puppy Class Application « Cape Province Dog Club

About You

Name*

First Last

Alternate handler

Address*

Street Address Address Line 2 City ZIP / Postal Code

Phone Home*

Phone Work

Cell

Email*

Is This Your First Puppy?*

Yes
No

Where Did you Hear About the Club?*

Your Vets Name

Other (Please Specify)

What Made You Choose Our Club?*

About Your Puppy

Dogs Name*

Breed*

Date of Birth*

DD

MM

YYYY

Sex*

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 Having

Do You Have Other Dogs?*

Yes
No

Your Other Dogs

Please list your other dogs separated by commas

Select a Class*

Puppy 1 for pups 8 - 14 Weeks
Puppy 2 for pups 15 Week - 5 Months
Junior Puppy Obedience for pups 5 -7 Months (only for pups who completed Puppy 2
Senior Puppy Obedience for pups 7-9 Months (only for puppies who have passed Junior Puppy Obedience)

Select the Appropriate Fee*

Full (R300 per age group)
Senior Citizen (R150 per age group)
Discounted fee for 5-7 month and 7-9 month classes (R500)

Engraved dog tag required - additional cost of R25.00

Order dog tag (@ R25) ?

Yes

Select a size

Small
Medium
Large

Dogs name*

Phone number*

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.