Note: The waiver is currently not available on-line, it will be in a day or so. In the meantime, it is fine to send in your registration without it.

All dogs and pups must be parasite free and have proof of vaccinations appropriate for age. Please mail (1773 Lake St., San Mateo, CA 94403), fax (650.574.9245), email (cerena.gooddog@gmail.com) or bring a copy of vaccinations to first class.

For class, unless otherwise instructed, please bring your puppy/dog wearing a plain buckle collar or harness and a regular (non-retractable 5 - 7 ft leash. Also bring a baggie / treat pouch full of 2 types of small yummy soft treats - bits of cut (not shredded) meat and cheese work fine too.

Please complete and submit  this form. Then be sure to send a check made out to Cerena Zutis to:
K9 Essentials
1773 Lake St.
San Mateo, 94403

Thank you!

* Required fields
Name *
E-mail Address *
Home Phone *
Work Phone
Cell Phone
Street Address *
City, State Zip *
Occupation(s)
Do you have a hearing problem or other physical limitations? *	Yes No
Dog's Name *
Breed *
Age *
Sex *	Male Female
Vet
Health Problems, if any
Medication/Supplements
Neutered *	Yes No
Age Dog Obtained *
From Who? *
History
Is Your Dog *	Outdoors Indoors Both
You dog ... *	Sleeps In Sleeps Out
Dog is left alone for how many hours a day? *
Amount of time in daily play w/ you
Amount of time in daily play w/ dogs
Time spent on walks
Diet/food
Amount per day
Free fed or scheduled mealtimes at
Current Training
Type of Collar
Reward(s) used for training
List specific problems you are having
How do you deal with these problems?
What is your dog's reaction?
What are your goals and expectations for your dog and this class?
Prior Training and Classes
Name of the course you are requesting *
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Time of course *
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Cerena Zutis www.k9essentials.com
Mail Address: 1773 Lake St., San Mateo, CA 94403     Email: cerena.gooddog@gmail.com
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