ONLINE CLASS or WORKSHOP REGISTRATION FORM
For Students who are paying ONLINE for their classes or workshops.  PLEASE NOTE:  YOUR SPOT IN CLASS IS NOT SECURED UNTIL WE ALSO RECEIVE YOUR PAYMENT.  
Sign in to Google to save your progress. Learn more
HAVE YOU DISCUSSED CLASS OPTIONS WITH AN INSTRUCTOR FIRST? *
IF YOU ARE A NEW STUDENT, PLEASE DO NOT COMPLETE THIS ONLINE REGISTRATION REGISTRATION OR ONLINE PAYMENT WITHOUT SPEAKING to Lana Kline, training director, or one of the other instructors at Paw & Hand first.  We want to be sure you are in the right class for you and your dog.  Dogs with dog/human or dog/dog aggression are not good candidates for group classes.  (We offer private lessons, too)  If you have not already done so, please contact Lana at trainingdirector@pawandhand.com . You can also call 570-980-1546, but email is highly preferred.  Thank you!
Which Session Are you Signing Up For? *
Owner's Name *
Street Address *
Apt #/PO Box #
if applicable
City *
State *
Zip Code *
Main Phone # *
Is Main Phone #
Clear selection
Secondary Phone # (if NA leave blank)
Is Secondary Phone #
Clear selection
Email Address *
Email is the preferred method of communication.  All class announcements are sent via email.  Add "trainingdirector@pawandhand.com to your contacts to prevent school emails from going to your spam box. 
Dog's Name *
(Call name; not registered name)
Dog's Breed or Mix of Breeds  *
Dog's Age *
please indicate years and/or months  (be sure to include the label(s) "years" and/or "months"
Dog's Sex
Clear selection
Please describe the main problem(s) or issue(s) you would like to resolve through training or want to have covered in class *
Class or Classes to Register (If reg for Workshop, write it in next question) *
Please check all classes you are taking with this dog, this session.  Not all classes are offered every session; please refer to the schedule on our website for what is currently offered.
Required
Workshop, Seminar or Misc/Special Class
Please fill in if class you are taking is not in the above list, or, if you are taking a workshop or seminar
First Preferred Day/Time *
Please check the schedule for the days/times your class(es) are being offered.  Review the current schedule.  By checking days/times, you are indicating you are eligible to take classes during those time slots.
Second Preferred Day/Time
Please check the schedule for the days/times your class(es) are being offered
Clear selection
Does your dog show any signs of aggression or reactivity to other dogs or other people?   *
If you answered "YES" or "MAYBE" to the question above, please give some detail
I attest that my dog is up to date on the following shots: *
Please check the boxes next to the vaccinations for which your dog is current.  Please add the dates in the question below.  NOTE:  IF THE VACCINE IS LISTED, IT IS REQUIRED.  ALSO NOTE--YOU MUST PROVIDE PROOF OF VACCINATIONS
Required
Date Rabies Vaccination was given *
Please indicate month and year of current rabies vaccination
Date of Distemper/Parvo/Parainfluenza *
Please list the date (or most recent date the above vaccine was given
Date Bordatella Vaccination was Administered *
Give date of most recent bordatella vaccine.  (We personally recommend the intranasal or oral version)
Amount Paid Online via SQUARE Online Store (pawandhandobedience.square.site)
Please write in below the amount you paid online for your class or workshop or seminar.  If taking a class, please speak to us if you haven't already, so we can make sure you are in a suitable class.  Workshop registrants do not need to call first.
Signature & Waiver *
BY TYPING MY NAME BELOW, I AM PROVIDING MY ELECTRONIC SIGNATURE, ATTESTING THAT: I understand that attendance at a dog obedience/agility training class or school related event is not without risk to myself, members of my family, guests who might attend, or to my dog, because some of the dogs to which I will be exposed may be difficult to control and may be the cause of injury even when handled with the greatest of care. I hereby waive and release Paw & Hand Obedience, hereinafter referred to as "Paw & Hand", its owner, employees, instructors, agents, and landlord, Mike Sullivan, his family and agents, from any and all liability of any nature for injury or damage which I or my dog may suffer, including, specifically but without limitation, any injury or damage resulting from the action of any dog or injury or damage arising from COVID-19. By signing this waiver, I voluntarily assume all risks related to exposure to COVID-19, or any communicable disease to either myself/handler, or my dog. . I expressly assume the risk of such damage or injury while attending any training session, or any other function, of Paw & Hand, or while on the training grounds or the surrounding area thereto. In consideration of and as inducement to the acceptance of my participation in any and all Paw & Hand events, classes, workshops, matches and other activities, I hereby agree to indemnify and hold harmless Paw & Hand, its owner, employees, instructors, agents, Milke Sullivan, his agents, from any and all claims, or claims by any member of a family or any other person accompanying me to any training session or function of Paw & Hand, or while on the grounds or the surrounding area thereto, as a result of any action by any dog, including my own. By participating in classes or events at Paw & Hand Obedience, I understand that both I and/or my dog(s) will be working with, exposed to or otherwise be in the presence of other dogs. I understand that neither Paw & Hand Obedience, its owner, employees, agents, and/or its instructors and landlord, do not warrant or otherwise insure my safety or the safety of my dog during events, classes or periods proceeding or following events or classes hosted by Paw & Hand Obedience. In the event that either my dog or I are injured by another dog prior to, during or following an event hosted by Paw & Hand Obedience, I agree to hold harmless Paw & Hand Obedience, its owner, employees, agents, instructors, and landlord for any injury suffered or sustained by myself and/or my dog(s). I understand that this hold harmless agreement is a condition of my participation at Paw & Hand Obedience classes and/or events and is part of the consideration exchanged between Paw & Hand Obedience  and me for the privilege of participating in events and/or classes at Paw & Hand Obedience. I understand that minors (under 18 years of age) are not permitted in the training building without a parent or adult guardian.  I have read this agreement and understand the conditions of participation.  I also acknowledge that I have read the payment, refund, weather cancellation and pottying policies information printed below. YOU MUST TYPE YOUR NAME BELOW TO ELECTRONICALLY SIGN THE WAIVER (Required)
Other Info *
Potty your dogs at the west side of the building.   YOU MUST CLEAN UP AFTER YOUR DOG!!! Poop bags and special poop cans are provided for you.  YOUR SPOT IN CLASS IS NOT GUARANTEED WITHOUT PAYMENT     **NO REFUNDS FOR CLASS FEES UNDER ANY CIRCUMSTANCES**  **Refunds for workshops and seminars will have a deadline date, after which refunds will not be issued.**  Students are responsible for checking the following resources for weather or emergency cancellations:  www.paw                                                                      andhand.com; Paw & Hand Obedience fb page and/or fb group, outgoing message on 570-980-1546; email; Paw & Hand Google Group.  Cancellations are posted 2 hrs prior to the start of the earliest class of the day or evening.  For example, Mon AM classes start at 9:30AM so the cancellation notice would be posted by 7:30AM.  If classes start at 6pm, the announcement will be made by 4pm.  
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy