DAY SCHOOL Registration

Please fill out the following form and submit.
Please sign our waiver at the bottom which you must sign before beginning day school.

For those interested in Private training. Consult fee is $99 payable to Heidi Benson.

Classes held at:

Discover Your Dog!
67 Tom Harvey Rd, Westerly, RI 02891
[email protected]
401.584.0676

Email *

How did you hear about DYD! DayCamp? *

Owners Name *

Cell Phone *

Home Phone *

Owners Work Phone (Emergencies Only) *

State *

Postal code *

Address *

City *

Emergency Contact Name & Phone Numbers *

Individuals authorized to pick up dog(s). Please list full name and phone numbers. *

Dog's name (must fill out new form for each dog) *

Breed *

Color *

Age *

Sex *

Male

Female

Is Your Dog Spayed/Neutered? *

Yes

To young

If Spayed/Neutered, At What Age? *

WEIGHT (approx) *

Veterinarian Info (name & phone #) *

Food Allergies/Restricted Food *

Where did you acquire your pup? *

How long have you owned him/her? *

What do you feed your dog & how often? *

Current medications *

Have you participated in any formal training w/ a professional in the past? *

Yes

If yes, who? (this helps us understand previous approaches to training) *

Any restricted exercises by veterinarian? *

Any limited or impaired sensory functions (deaf/ blind)? *

Any behavioral concerns or issues (resource guarding behaviors, storm phobias, noise phobias,separation anxiety, sibling rivalry, etc)? *

What things (food, toys, ppl, dogs, other animals, etc) does your dog love the most? *

What things (food, toys, ppl, dogs, other animals, etc) does your dog dislike the most? *

What are the 3 most important issues your dog(s) have that you hope to resolve? *

Any other information you feel is important for us to know? *

Which DYD! DaySchool program are you interested in?

14 day program + 4 private lessons w/owners - Free email, phone support

21 day program + 5 private lessons w/owners - Free email, phone support

30 day program + 5 private lessons w/owners-Free email, phone support

40 day program + 6 private lessons w/owners-Free email, phone support

Consult fee is $99 payable to Heidi Benson. By signing your full name below electronically, you confirm you have read & agree to the requirements.

Sign Here *

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Select Today's Date By Clicking This Box Below *

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