WINTER 2019 Wayne County Class Registration Form
Palmyra-Macedon Middle School, 163 Hyde Parkway, LGI Room, Palmyra, NY
Wednesday Evenings,January 9 - February 27, 2019
No classes February 20, 2019.
Class Selection: ___ Puppy Kindergarten (8-20 wk. old) 6:00 - 6:45 PM ___ Teen Puppy (6 -14 mo. old, 30# and under full grown) Small Breeds 7:00 - 7:45 PM
____Teen Puppy (6 -14 mo. old, over 30# full grown) Med-Lge Breeds 8:00 - 8:45 PM
Cost: Puppy Kindergarten and Teen Puppy $102.60 ($75.60 for Rescue and Shelter adoptees with proof of adoption)
All fees include tax.
Registration fees are non-refundable once classes start. Refunds requested before classes start will be subject to a 15% processing fee. Returned checks are subject to a $25 service charge.
Contact Information:
Name ________________________________________________________________
Address ______________________________________________________________
City __________________________ State _____ Zip Code____________
Email Address __________________________________________
Home Phone ___________________ Cell Phone __________________ Work Phone/Ext _________________/_______
Canine Companion Information:
Dog's Name _______________ Breed ________________________ Dog's Age _______ Sex: Male ___ Female ___
Spay/Neuter: Yes _____ No _____
Does your puppy/dog have any allergies? ______If so, what ____________________________________
Is your puppy/dog good with other dogs?________________________________________________________
Vet's Name _________________________________________ Vet's Phone ___________________________
Adopted From: ___________________________________________________ Animal ID #__________________
Date Adopted ___________________________ (Adoption must be within one year from start of first class)
MALE DOGS ONE YEARS OLD AND OLDER MUST BE NEUTERED TO ATTEND CLASSES.
NOTES:
1. Puppies/dogs must be dog and people friendly!
2. Puppies/dogs do NOT attend the first class (dog guardians only!).
3. Orientation starts at 7:00 PM for all 3 classes in the LGI Room.
4. Please arrive 10-15 minutes prior to the start of the first class for check-in.
5. Bring vaccination record to first class. Record will be returned to you.
Send completed registration form and check to: Paws-i-tive Behavior