Hollowell Academy of Dog Training

                 Hollowell Academy of Dog Training
    Puppy Kindergarten Application for pups 8 weeks to 4 months old


Owner’s Name____________________________Home Ph_________________Work Ph_______________
Address________________________________________________________________________________
City__________________Zip Code____________ Email Address__________________________________
_
Dog’sName__________________________Age______Breed______________Sex___Spayed/Neutered?__
Veterinarian _________________________________Date of last DHLPP* _______Date of Rabies_______

*No puppy will be allowed to attend classes without a veterinarian’s statement that the puppy is healthy,
has had vaccinations appropriate for its age and a negative fecal exam.

Does your puppy have any specific behavior problems we should know about before training begins?
Please explain: __________________________________________________________________________
______________________________________________________________________________________
Waiver
I/we understand that attendance at any dog training class is not without risk to myself, members of my family, or my dog
because some of the dogs to which I may be exposed may be difficult to control and may be the cause of injury even when
handled with the greatest care.

I hereby waive and release, Diane Laratta, Hollowell Kennels, Hollowell Academy of Dog Training, Dorothy Miner, Jo Ellen
Gellart, Catarina O'Sullivan, Joann Monfort, Carla Amstutz and any employees, subcontractors, officers, members and agents
from any and all liability of any nature for injury or damage which I or my dog may suffer, including specifically, but without
limitations, any injury or damage or death which I or my dog may hereafter suffer,including specifically, but without limitation,
any injury or damage or death resulting from the action of any dog, and I expressly assume the risk of such damage or injury or
death while attending any training session, or any other function of the training organization, or while on the training grounds
or surrounding area thereto.

In consideration of and as inducement to the acceptance of myself and my dog for training by this training by The Hollowell
Academy of Dog Training, I hereby agree to indemnify and hold harmless the Hollowell Academy of Dog Training, all
employees, subcontractors, volunteers, officers, members and agents from any and all claims, or claims by any member of my
family or any other person accompanying me/us to any training session or function or while on the training grounds of the
surrounding area thereto as a result of any action by any dog, including my own dog, and from any claims by any person at any
training session or function or while on the training grounds or surrounding area thereto as a result of any action by my own
dog.

Signature(s) of Dog’s Owner(s)_______________________________________ Date________________

Return this form together with a check for $65 made payable to:
Diane Laratta, 1170 N. Wapak Rd., Elida, OH 45807.

Please indicate day you prefer to attend class: Tuesday 6 PM___ Thursday 9 AM___ Thurs 6 PM____
Next classes start the WEEK of April 5, 2010. Class size is limited. To ensure a spot in the class of your
choice, please send your application and fee ($65.) to the above address at least one week prior to class
start date.
Your application for class will be acknowledged by USPS mail, generally the week before classes begin!

                           The Hollowell Academy of Dog Training
                                    Class Application for dogs over 5½ months old

Please mark Class Selection(s) Below          Day & Time I prefer to attend_______________

Beginner’s_____Canine Good Citizen______ Top Dog______ Agility for Fun _____ AgilityII____Freestyle Dance____
Rally-O & Advanced_____Tracking _____Flyball_____ Therapy Dog Prep Class_____Senior Citizens Class_____

Owner’s Name____________________________Home Phone________________Cell Ph_______________
Address_________________________________________________________________________________
City ________________________________Zip Code_________EMail_______________________________
Dog’sName______________________Age_______Breed_______________Sex___ Spayed/Neutered_____
Veterinarian ______________________________Date of last DHLPP* _________Date of Rabies______

*No dog will be allowed to attend classes without a veterinarian’s statement certifying that the dog is healthy and has had
appropriate vaccinations for its age, including a rabies vaccination. We also require a negative fecal exam.

Does your dog have any specific behavior problems we should know about before training begins? Please explain:________
___________________________________________________________________________________________________
Has your dog ever bitten anyone? _______ If so, please explain circumstances_____________________________________
___________________________________________________________________________________________________
What would you like to accomplish in this class?____________________________________________________________
___________________________________________________________________________________________________
Waiver:
I/we understand that attendance at any dog training class is not without risk to myself, members of my family, and my dog because some of the dogs to which
I may be exposed may be difficult to control and may be the cause of injury even when handled with the greatest care.
I hereby waive and release, Diane Laratta, Hollowell Kennels, Hollowell Academy of Dog Training, Dorothy Miner,   Jo Ellen Gellart, Catarina O'Sullivan,
Joann Monfort and Carla Amstutz, as well as any employees, officers, members and agents from any and all liability of any nature for injury , damage, or
death which I or my dog may hereafter suffer, including specifically, but without limitation, any injury or damage or death resulting from the action of any
dog, and I expressly assume the risk of such damage or injury or death while attending any training session, or any other function of the training organization,
or while on the training grounds or surrounding area thereto.
In consideration of and as inducement to the acceptance of myself and my dog for training by this training by The Hollowell Academy of Dog Training, I
hereby agree to indemnify and hold harmless the Hollowell Academy of Dog Training, all employees, subcontractors, volunteers, officers, members and agents
from any and all claims, or claims by any member of my family or any other person accompanying me/us to any training session or function or while on the
training grounds of the surrounding area thereto as a result of any action by any dog, including my own dog, and from any claims by any person at any training
session or function or while on the training grounds or surrounding area thereto as a result of any action by my own dog.

Signature(s) of Dog's Owner(s)________________________________________________Date_________

Return this form with a check for $95 for Beginner’s Obedience,   $55 Senior Citizen Class, $80 for Canine
Good Citizen, Top Dog, Agility For Fun, and Agility II, $65 for Tricks.$80 for Rally-O, Flyball or Canine
Freestyle. $40 for Therapy Dog Prep. $120. for Tracking.

Mail to: Diane Laratta, 1170 N. Wapak Rd, Elida, OH 45807. Indicate which day(s) you prefer to attend
class by circling one or more of the classes below. Questions? Call 419-339-3208 (Training Building).

Beginner’s: Tuesday 7:00 PM,Thursday 10AM or 7PM or Saturday 10AM (winter only);   Top Dog: Monday 6 PM or
Wednesday 9 AM; Flyball: Thursday 8:30 PM; Canine Good Citizen:: Wed 10AM or Wednesday 7:00PM,Therapy Dog Prep
Class: Wednesday 6 PM or Thursday 11AM.   Tracking: Saturday (Call for info) Agility For Fun: Wednesday 11AM or
Wednesday 7 PM. Agility Advanced Wednesday - 8 PM;   Senior Citizens Beginners: Wednesday 9AM; Tricks Mon. 7PM
NEW classes start the week of April 5, 2010. CLASS SIZE IS LIMITED! To ensure a spot in the class of your
choice, please send your application and fee to the above address at least one week prior to class start date.

Your application for class will be acknowledged by USPS mail, generally the week before classes begin!

Print Pg. 1 for Beginner's Obedience and classes beyond.
Print Pg. 2 for Puppy Kindergarten

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Our subsidiaries include:
My Dog’s Favorite Place Doggie Daycare OPEN 6:30 AM to 5:30 PM
Hollowell All-Breed Dog Grooming, AM & PM Appointments M-F & Saturday
Hollowell Do It Yourself Dog Bathing
Hollowell Lending Library of Dog Books
Dog Toys: Plush Toys, Cow Hooves, Rope Toys, Tennis Balls, Raw Hide, Antler Chews
Training Equipment: Leashes and collars