The grass is Always Greener on … ON THE OTHER SIDE OF THE FENCE, a non-profit corporation dealing with the prevention of cruelty to animals and global education EIN #86-1174463 UBI #602-649-202 CHARTER #E00882841 520 County Road 5351, Poplar Bluff Mo. 63901 Phone- 573-686-7551 Fax- 866-240-8070 jaymeeyh@theothersideofthefence.org www.theothersideofthefence.org/ Obedience Class Registration Name _______________________________________________________________________________ Address_____________________________________________________________________________ Telephone: ______________________________________ E-mail please provide email for confirmation of class registration_________________________________________________ Dog: Name_________________________________________ Breed _______________________ Age______ Female____ Male____ Neutered/Spayed Yes____ No____ What would you like help with? ___________________________________________________________________________ List some commands your dog has already learned. ___________________________________________________________________________ What type of activities do you currently do with your dog. ___________________________________________________________________________ Which class are you attending: Puppy Kindergarten____ Puppy Prep____ Basic Obedience____ Private Lessons____ Class Starting Date:_______________________ Time:____________________ Number of people attending the Orientation____ {please do not bring your dog to orientation!} Amount Enclosed: $________________ I attest that my dog has had the following vaccinations on the dates indicated: Distemper:__________ Parvo:___________ Parainfluenza:___________ Rabies:___________ I UNDERSTAND THAT ATTENDANCE AT A DOG TRAINING FACILITY IS NOT WITHOUT RISK TO MYSELF, MEMBERS OF MY FAMILY, GUESTS WHO MAY ATTEND, OR MY DOG. I HEREBY WAIVE AND RELEASE ON THE OTHER SIDE OF THE FENCE, ITS INTRUCTORS OR AGENTS FROM ALL LIABILTY OF ANY NATURE RESULTING FROM ANY DOG WHILE ON OR IN THE TRAINING GROUNDS OR SURROUNDING AREA. Signature: Make checks/money orders payable to: The Other Side of the Fence and Mail to: 520 CR 5351, Poplar Bluff, Mo. 63901 Please bring the dog's vaccination records with you to Orientation or to the first night of class or include a copy (not your original) with your registration form. Was Dog Adopted from On The Other Side of the Fence? Yes___ No___ Would you like to be on our mailing list? Yes ___ No ___ How did you find out about this class? If from other source please list. Our Newsletter___ Our Website ___ Friend/Family ___ My veterinarian ___Other___________________________ Are you a Member of On The Other Side of the Fence?__________ Would you like to become a member?_________