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Diamond In The Ruff Dog Training at Norwalk Veterinary Hospital and The Boarding House, .
JOYCE DIAMOND, CPDT-KA
726 Connecticut Ave. Norwalk, Ct.   *  PHONE: (203) 866-2383  *  

PLEASE COMPLETE APPLICATION - PRE-REGISTRATION IS REQUIRED


OWNER'S NAME
ADDRESS
CITY
STATE
ZIP
HOME PHONE
WORK PHONE
CELL PHONE PROVIDER
CELL PHONE
FAX
EMAIL ADDRESS
EMERGENCY CONTACT
CONTACT'S PHONE
DOG'S NAME
DATE OF BIRTH
OWNED SINCE
BREED
DOG'S BACKGROUND?
VETERINARY
HOSPITAL
VETERINARIAN'S
PHONE
IS DOG IN GOOD HEALTH?
IF NO,
EXPLAIN
IS DOG ON ANY
MEDICATIONS?
IF YES,
EXPLAIN
DOES DOG PLAY OFF-LEASH WITH OTHER DOGS?
FREQUENCY
OF PLAY?
HOW DOES
DOG PLAY?
IS DOG AFRAID OF ANYTHING OR ANYONE?
IF YES,
EXPLAIN
WHAT DOES DOG DO?
HAS DOG
GROWLED AT
ANYONE?
IF YES,
EXPLAIN
HAS DOG
EVER BITTEN?
IF YES,
EXPLAIN
ANY FORMAL TRAINING?
TRAINER
OR SCHOOL
LEVEL OF
TRAINING
DOG KNOWS
SIT
DOWN
STAY
LEAVE IT
COME
HEEL
HOW DOES DOG GREET PEOPLE?
REFERRED TO
BANDILANE BY


PLEASE REGISTER MY DOG FOR THE CLASSES BELOW:
Please see    -  Pet Training  for descriptions







TUITION
6-Week Classes
*Plus Applicable 6.35% CT Sales Tax

\
Distemper and Parvovirus, Rabies* -- Titers Accepted
*Rabies not required for Puppy Class

Bordetella (Kennel Cough) also required for Daycare

__________________________________________________________________________________________________________________

BY APPOINTMENT ONLY  -  PLEASE REGISTER MY DOG FOR:
DAYCARE
PRIVATE LESSONS

__________________________________________________________________________________________________________________

COMMENTS:


__________________________________________________________________________________________________________________

I will not hold Bandilane School for Dogs, Inc., 80 Largo Drive, Stamford, CT, Joyce Diamond,
any trainer teaching at Bandilane School for Dogs, Inc., any employee, groomer, or anyone
associated with them responsible for injury to persons or property caused by my dog or any dog
brought by me. Nor will I hold them responsible for physical harm which might come to me or my dog
while on the premises of Bandilane School for Dogs, Inc. or off premises in a group or private lesson.

I agree to the terms above.






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