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Name *

First

Last

Your details:

Contact details:
Please provide your e-mail address and at least one phone number

Email *

Mobile (or landline if no mob,) *

Home *

Work *

Your dog's details:

Name *

M/F? *

Male Female

We can't always tell by your dog's name if you have a boy or a girl, so please let us know

Age *

D.O.B. *

Necessary for pups under 18 weeks old. For rescue dogs if unsure, please enter approx. date of birth

Vaccinated? *

1st vacc 2nd vacc Fully

Puppies can attend from 1 week after their first vaccination

Confirm age *

AGILITY TASTER - I confirm that my dog is at least 8 months old AGILITY FOUNDATION - I confirm that my dog is at least 12 months old for agility foundation

Breed *

How long have you owned your dog? *

Brief description of your dog: *

Vet's name & phone no. *

In case of emergencies, please provide preferably an emergency phone number

Where did you obtain your dog? *

Registered breeder Private sale Rescue Other

Health

Any medical or health conditions we should know about in case of incident, or to assist with your training:

Your health *

Your dog's health *

Please read & confirm: *

I have read the terms & conditions, and I confirm that my dog is not aggressive or reactive TOWARDS people or dogs, nor has any other significant behavioural problems requiring 121 help.

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