Swims Sign Up

Your Information:

Owner/Handler's Name
Address
City
State
Zip
E-mail
Home Phone
Cell Phone

Your Dog's Information:

Dog's Name
Dog's Gender
Spayed/Neutered
Date of Birth
Breed
Weight
Color

Dog's Temperament: -- Select Temperament -- Friendly Shy Nervous Outgoing Other

Other Temperament:

Dog's Swimming Ability: -- Select Ability -- Poor Fair Good Great Unknown

Dog's Swimming Experience: -- Select Experience -- River/Pond Pool Ocean Hose

Dog's Swimming Enjoyment: -- Select Enjoyment -- Love Like Dislike Hate Unknown

Does your Dog Like:

Toys: Yes No

Treats: Yes No

Your Dog's Actvities:

Agility: Yes No

Show: Yes No

Obedience: Yes No

Rally: Yes No

Field: Yes No

Flyball: Yes No

Frisbee: Yes No

Health Information

Swim Sessions

How soon do you want to start? -- Select Number of Weeks -- 1 Week 2 Weeks 3 Weeks 1 Month Don't Know

Has your dog completed its Initial Swim Evaluation? Yes No

Which day of the week do you prefere? -- Select Day of Week -- Wednesday Thursday Saturday

Enter additional information in the space provided below:

ALL DOGS AND PUPPIES MUST HAVE UP TO DATE HEALTH INOCULATIONS

ALL DOGS MUST HAVE AN INITIAL SWIM EVALUATION!!!

Once you have submitted this Sign Up Form, and paid for your sessions, our Swim Instructor, Carrie, will contact you to schedule your swim sessions and evaluation (if needed).

WHERE DID YOU HEAR ABOUT US?

Internet

Google

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Our Website

Other Website

Word of Mouth

Ad

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Member/Student