Information about the Handler
Person handling the dog to complete this form.
Your Full Name *

Email *

Phone Number *

Postal Address *

Is the handler over the age of 17? * YesNo
If under 17, please specify     

Have you attended dog obedience classes before? * YesNo
Are you currently training with anyone? YesNo
If yes to either question, please provide details on your dog training history:

Dogs Vaccinations* Please by aware your application for enrolment will not be accepted for processing without current up-to-date vaccination information. You will also need to submit evidence verifying your vaccination information.

Please submit a current vaccination certificate (including Bordetella for kennel cough).

Vaccination cards need to be scanned or photographed and attached here with your enrolment form, without them your application can not proceed.

Click here for a example of what we need on your vaccination card.

Yes, my dog is currently Vaccinated
My dog is Under 12mths oldOver 1yr old

Please provide dates for last 4 vaccinations:
     

Next Vaccination Due:
Vaccinated for Bordetella Kennel Cough YesNo

Please attached proof of vaccination dates from your vaccination book

I have attached my dogs vaccination records* YesNo

Information about the Dog
*
*
Is this a Dog or a Bitch? * DogBitch
Dog's Date of Birth:   *

Is this your first dog? *   YesNo
Do you have multiple dogs in your household? * YesNo
If yes, how many dogs do you have in your household?     

Was your dog a rescue? *   YesNo
How long has your dog been in your household?

Is your dog an "Inside Dog" or an "Outside Dog"? Select all that apply

Allowed InsideNot allowed inside at allSleeps InsideSleeps OutsideDog is trained to use a crate insideDog has an enclosed kennel and run outside
Other     If 'Other' is selected, please give details below:

How would you describe your dog? Select all that apply
Understanding your dog's personality and behavioural traits helps us to be better prepared.
We do not pre-judge your dogs based on its breed or history

FriendlyConfidentWants to pleaseIndependentExcitableLazyLoves foodLoves toysLikes other peopleLikes other dogs

TimidScaredFearfulDominantAggressiveDislikes other dogsBitingNippingJumpingBarkingChasingDislikes MenDislikes WomenPreviously AttackedDoesn't like being touchedDoesn't like collar being touched

Other     If 'Other' is selected, please give details below:

What is your main reason for coming to dog obedience?

How did you year about Waikato Canine Obedience Club? Select all that apply
GoogleFacebookWord of MouthBrochureSign
Other     If 'Other' or 'Word of Month' has been selected, please give details below:

Anything else we should know?

Emergency Contact *
In the event of a handler emergency please provide a suitable contact person.

DECLARATION *
I declare that I am responsible for my own safety and insurance during the course/s. I undertake and agree that neither myself nor any other member of my family or persons attending with me will make any claims against the Waikato Canine Obedience Club Inc or anyone else connected with this club in respect of any loss or injury to property, canine or person which may be sustained. I am also aware that any information or knowledge acquired or learnt on the course is strictly for personal use.
Yes, I accept this declaration.

TERMS & CONDITIONS *
By ticking this box it indicates you have read, understand and accept our Terms & Conditions Policy.
Yes, I accept your terms & conditions and wish to proceed with my enrolment.