The Canine Connection | Positive Dog Training & Behavior Solutions

Located in Chico CA
(530) 345-1912

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Online Registration

Group classes are appropriate for dogs that are comfortable being around new dogs and people. If you are unsure whether group classes are appropriate for your dog, please contact us at office@thecanineconnection.com to arrange an evaluation.

Please fill out the form below as completely as possible. Missing information may result in a delay in getting you registered.

Be sure to check the appropriate boxes in the Acknowledgments and Permissions section at the end of the form.

Class Information

Please indicate the class for which you are registering (SCROLL down to find the correct class):

Where did you hear about The Canine Connection?

Owner Information

Press "Tab" to move between fields.

First Name:

Last Name:

Email Address:

Mailing Address:

City: State: Zip:

Home Phone: Cell Phone: Work Phone: (if OK to call at work)

Earliest we can call at home:

Latest we can call at home:

Pet Information

Dog's Name: Breed:

Sex: Male Female Neutered/Spayed? Yes No

Dog's Age: Date of Birth (if known): Age of dog when adopted:

Where did you get your dog?

Veterinarian's Name:

Vaccination status:

Does your dog have any current health problems or physical limitations? Yes No
If yes, please describe:

How would you best describe your dog? (Check all that apply.)
Confident Timid Sensitive Fearful of new people	Fearful of new dogs Loves to play Stays focused Perpetual Motion Machine	Reserved Loves food treats Tires easily ADD (Attention Deficit Disorder)	Picky eater Loves toys Bonded to me Other (specify below)
Other:

What does your dog do when he or she meets a new DOG? (Check all that apply.)
Wiggles Lunges Rolls Over Growls Body stiffens	Hides Barks Wants to Play Acts friendly Stares	Cautiously approaches Urinates Seems Stressed Seems Relaxed Seems tense

Does your dog act differently toward different types of dogs (e.g. big, small, different breeds)? Yes No
If yes, please describe:

What does your dog do when he or she meets a new PERSON? (Check all that apply.)
Wiggles Lunges Rolls Over Growls Body stiffens	Hides Barks Wants to Play Acts friendly Stares	Cautiously approaches Urinates Seems Stressed Seems Relaxed Seems tense

Does your dog act differently toward different types of people (e.g. men, women, children)? Yes No
If yes, please describe:

Has your dog ever snapped at or bitten: Another dog ? An adult? A child? Don't know
If yes, please describe:

Where does your dog sleep at night?

Where does your dog stay during the day?

Other pets in household (age and type):

What behaviors does your dog already know? (e.g. Sit, Down, Fetch, Tricks)

Please help us help you! Tell us what you most want to get out of training - what are your GOALS for you and your dog?

Other Information

Number of adults and children (ages) in household:

	Number	Names
Who will be attending class with your dog?
Adults
Children*
	Over the age of 12 - Please see class policy about children in class.*

Do YOU have any limitations (physical or other) that will affect your training with your dog? Yes No
If yes, please describe:

Is there anything else we should know about you and your dog?

Acknowledgments and Permissions

REQUIRED FOR GROUP CLASSES:
Please read the Class Policies and input your initials in the box below before submitting your registration.
I have read the class policies and understand and accept them.
Please initial

REQUIRED FOR BEHAVIOR CONSULTATIONS: (optional for others)
I grant permission for any behavior reports to be shared, verbally or in writing, with my veterinarian.
Please initial

WAIVER, RELEASE AND INDEMNITY AGREEMENT ACKNOWLEDGMENT AND ASSUMPTION OF RISKS AND HAZARDS
Please read the waiver and input your initials in the box below before submitting your registration.
I have read the waiver and understand and accept it.
Please initial

Please enter code from above image in box below.

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Office@TheCanineConnection.com 530-345-1912

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Association of Pet Dog Trainers • International Society of Animal Behavior Consultants

This site is dedicated to Makai, Labrador extraordinaire, soul dog, and friend.

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Canine Connection is located in Chico CA and serves the following communties: Butte County, Northern California, Paradise, Durham, Sacramento, Orland, Oroville, Magalia, Hamilton City, Yuba City, Biggs, Gridley, Marysville, Red Bluff, Redding, Cottonwood