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Puppy Socialisation Registration Form

Handler/Owner Name: __________________________________________ Date: ________

Email: _______________________ Tel nr.: _______________________

Address: _______________________________________________________

Family in home: __________________________Type of home: ________________________
(Who lives in the house) (Flat/Townhouse/House with yard)

Puppy’s Name: __________________________________________

Species: CANINE Breed: _________________________________

Age Acquired: ____ Current Age: _____ Gender:____

Have you ever trained a dog before: ______ If so, when & where: ________________________

Please state briefly, any problems that you are experiencing with your puppy?

Please state your expectations for your puppy.

Do you or your puppy have any disabilities or health problems that could affect you or your puppy’s training? Please state

Where did you hear about our puppy socialisation classes?

I the undersigned waive and release Animal Minds Behavioural Practice, and Anlè Allison, from all and any liabilities of any nature, for injury or damage or other, which I, or my dog could suffer. I hereby agree to indemnify and hold harmless, the Practice and any employees and/or agents, while on the grounds or in the surrounding area, as a result of any action by any dog, including my own.

Owner/Handler Signature