<p> Dog Training School - Enrolment Form</p><p>In which class would you like to enroll*? Select a Class</p><p>Start Date: Click here for start date *If you are unsure, please advise your dog’s DOB and we will book appropriately</p><p>Your Details Full Name:</p><p>Address:</p><p>Email Address:</p><p>Mobile Number:</p><p>I found out about RSPCA ACT’s Dog Training School: (please select one) ☐ At time of Adoption ☐ Internet Search ☐ Facebook ☐ Instagram ☐ RSPCA Newsletter</p><p>☐ Already on waiting list ☐ Recommendation ☐ RSPCA Newsletter ☐ Other:</p><p>Dog’s Details </p><p>Name: Age/DOB: Gender: Select</p><p>Breed: Colour: </p><p>Any special health requirements? Select</p><p>If yes, please give details:</p><p>Background Questionnaire</p><p>To ensure that you and your dog have a great experience at training, please assist our instructors by providing the following background information.</p><p>1. Where did you get your dog from? (eg breeder, shelter, gumtree etc) </p><p>2. At what age did your dog join your home?</p><p>3. Why did you decide to get a dog?</p><p>4. Why did you select this dog?</p><p>5. What do you like best about your dog?</p><p>6. Are there any behaviours or things that you would like assistance with? ☐ No ☐ Yes – please provide details</p><p>Page | 1/3 RSPCA ACT - Dog Training School 7. What are your main training goals? (what would you like your dog to learn?)</p><p>8. How much time does your dog spend</p><p>Outside: hours per day </p><p>Inside: hours per day</p><p>Without humans: hours per day</p><p>9. What games do you play with your dog?</p><p>10. Has your dog ever shown aggression to: (select all that apply)</p><p>☐ People within your household ☐ People outside of your household ☐ Dogs within your household ☐ Dogs outside of your household Please describe the incident(s):</p><p>11. Do you currently have any other dogs?</p><p>☐ No ☐ Yes Number of dogs:</p><p>Dog 1 Breed</p><p>Gender: Are they desexed? Select Age:</p><p>Dog 2 Breed</p><p>Gender: Are they desexed? Select Age:</p><p>12. How many people are in your household?</p><p>Adults:</p><p>Children:</p><p>13. Is anyone from your household attending training with you?</p><p>☐ No</p><p>☐ Yes Names:</p><p>Page | 2/3 RSPCA ACT - Dog Training School Ages:</p><p>Payment – Dog Training School</p><p>I would like to pay by: ☐Over the phone ☐Mastercard ☐VISA</p><p>Name on Card: Card Number: Expiry Date: CCV Number: </p><p>☐ I will upload my dog’s current C5 vaccination certificate with my booking form; or</p><p>☐ I will email my dog’s current C5 vaccination certificate to [email protected] within 24 hours of submitting this form (otherwise my booking will be cancelled)</p><p>☐ I give permission for my, my dog’s and any household members (that attends classes with me) image to be used to promote RSPCA programs in the future; web, social media and print</p><p>☐ I confirm that all information above is correct and understand the terms and conditions below</p><p>Signature: (type full name to confirm) Date: Select Date</p><p>Terms and Conditions</p><p> Bookings will not be confirmed without payment.  RSPCA ACT reserves the right to cancel or change any advertised activity when unavoidable.  Program activities are conducted by RSPCA ACT staff and contractors, on occasion with the assistance of volunteers (all hold current working with vulnerable person’s cards).  For safety reasons, participants must wear the appropriate clothing. Appropriate clothing includes a hat and closed toe shoes. Thongs and sandals are not acceptable footwear. A participant will be refused entry if not dressed appropriately. Participants are advised to wear sunscreen.  Participants can bring along one family member to the orientation (space limitations) and more family members to the training sessions. Each child must be supervised by an adult. Children must be able to participate in the orientation or training sessions without disrupting the class, otherwise you may be requested to leave the session and will not be credited for the missed session.  If a participant puts themselves, others or animals at risk, they will be removed from the program  Participants that do not attend classes for more than 12 months are required to repeat the orientation and introduction classes  100% refund will be given if more than 7 business days’ notice has been given prior to cancellation  50% refund will be given if less than 7 business days’ notice has been given prior to cancellation  No refund will be given if cancellation is made on or after commencement of classes  A refund may be given for special circumstances at the discretion of the Customer Service Manager. Requests for refund must be submitted via email to [email protected]  While the RSPCA ACT takes all reasonable precautions to ensure the safety of participants, all participants enter at their own risk and consent to taking part in training sessions. By enrolling in these programs you acknowledge that you understand this disclaimer and release RSPCA ACT and its employees, agents, volunteers and contractors from any liability whatsoever, to the extent permitted by law</p><p>Page | 3/3 RSPCA ACT - Dog Training School Please email completed form, along with vaccination certificate to: [email protected]</p><p>Page | 4/3 RSPCA ACT - Dog Training School</p>