Ohkom Farms Class Registration 2009

                             (Only one completed registration needed per year, per dog)  

Name____________________________________Phone #________________________

Address___________________________________City__________________Zip______  

E-Mail Addy if not on File_____________________________to receive updates   

Dogs Call  Name____________________________________________

Dogs Name to be put on certificate for course completions/ year end awards

_______________________________________/________________________________ 

Breed_________________________________________________

 Birthdate___________________Age_______________________Sex________________

 Spay/Neutered Yes or No, (circle) Appt date_____________________ 

 Vaccinations were given on what DATE____________________required yearly

(DHLPP,Rabies and Bordatella)

Last stool sample___________________ No dogs will be permitted if they have worms.

Please ask your vet to mark results on your record.

Flea Preventative___________________ Required in the summer months

 < Students:IF not current  ENCLOSE A COPY OF YOUR VACCINATION RECORDS>

 Fee Enclosed____________________           Fee Enclosed___________________

Class registering for______________             Class registering for______________

Start Date______________________            Start Date______________________

Make Check out and mail to: Linda  Scopa PO BOX 164 Forbes Road , PA 15633

Total enclosed Check____________________ Cash____________________________

No Refunds.  You are responsible to attend classes.    If a class of similar lessons is available you may do a make up with that class at no charge, otherwise you must schedule a private.For obedience classes, seven of the eight are required to receive a certificate.  Socialization classes all must be attended, make ups are recommended if you miss.

I have read and understand the above.  

Signature Required __________________________________________date__________