First Name*

Last Name*

Address

City

State/Province

Zip/Postal Code
 - 

Email*

Home Phone

Cell Phone*

Alt Email

Text/Pager Email

First Name:*

Last Name:*

Your full address*

Cell Phone: *

What is the best way to reach you?
Choose one: Cell Phone Email Home Phone Text Work Phone

What is your dog's name?*

What is your best guess as to what your dog's breed(s) are*

What age will your dog be at the class start date?*

Is your pet(s) Spayed or Neutered?*

Is your dog good with other dogs? Is your dog people friendly? This just. helps us to know how to keep you and your dog safe as we navagate class. It does not mean you cannot bring your dog.
Choose all that apply: Yes No Unknown

Is your dog current : Rabies, Distemper Combination, and Bordetella?*
Choose one: Yes No Unknown

I understand that if I wish to cancel, I must give notice to MARS Training Department at least 1 week (5 business days) prior to the first class in order to receive a full refund If I cancel less than 5 days before class, there is a $25 non-refundable fee for holding a spot that could otherwise have been filled. You will receive a confirmation e-mail shortly. Your spot is not confirmed until payment is made. If you do not receive an e-mail within a few days, please contact the Training Department at training@midwestanimalrescue.org You will be e-mailed a Square invoice. Payment must be received before you can be officially enrolled in the class. I have read and agree to the cancellation policy. *
Choose one: Yes No

By submitting this form, I attest that the information I have provided on the form is true and accurate. I acknowledges and agrees that owning any animal, including a dog, has inherent risks, including but not limited to the risk of dog bites to humans or other animals. The client agrees they are then liable for medical, and legal, fees associated with such incidence(s) and/or bite(s). The client acknowledges that MARS does not offer any guarantees for the provided service(s). Dog training results are dependent on the participation of owners, family members, and other home occupants’ during and after the training session(s). Some behaviors may not be able to be eliminated or corrected completely, and management of the behavior would then be the goal. I acknowledge and recognize that I will be responsible for my pet’s behavior prior, during and after class. I will be responsible for any liability that my pet may cause, including but not limited to: property damage, injury to another dog or human, etc. I agree and assume such risks and forever release, discharge and hold harmless Midwest Animal Rescue & Services, it’s officers, staff, other volunteers and any other agent from any liability or claim of liability of any type which might arise as a participant of training at MARS. *