Class Registration

Select A Class: *
Name *
E-mail Address: *
Mailing Address *
City *
State *
Zip Code *
Home Phone *
Cell Phone
Work Phone
Dogs Name *
Breed or Mix Type *
Sex *	Male Female
Age *
Is your dog current on all shots, including the Kennel Cough vaccination? *	Yes No
Has your dog been spayed or neutered? *	Yes No
Name of your Veterinary Clinic:
How did you hear about MerryMac? *
Is there anything else you would like us to know about your dog?
Terms And Conditions: Cash, Check, Visa & MasterCard are accepted. There will be a $25.00 returned check charge. Class fees do not include required equipment. Class fee balance & equipment fees are due at the first class. Class fees & equipment fees are non-refundable & non-transferable to another dog or other persons. If one or more class sessions are missed, transfer to another class may be subject to a class transfer fee. If two or more classes are missed, MMDT requires making those classes up before a diploma will be awarded. Children over age 12, may participate in group lessons. Those under age 10, may not attend group class sessions. Vacination Records: A copy of your dogs vaccination records will be required at time of class start date. Required vaccines for all dogs are: Parvovirus, Distemper, Hepatitis, Bordetella and Rabies. MerryMac does recognize alternative vaccination protocols. Please discuss any alternative vaccination protocols are discusses on an individual basis. General Agreement: In consideration of the acceptance of this registration, and the holding of classes or private lessons, and the opportunity to have the dog participate, I agree to hold MerryMac Dog Training, Tina and Jim McCain, or any MerryMac employees, the premises upon which the classes are to be held, harmless from any claim for the loss or injury which may be alleged to have been caused directly, or indirectly to any person or thing by any act of dog or person while in or upon the premises, grounds, or near any entrance thereto, or any off-site training premise or location. I personally assume all responsibility and liability for any such claim. I further agree to hold the aforementioned parties harmless from any claim of loss of this dog by disappearance, theft, death or injury to be caused or alleged to be caused by the negligence of the parties aforementioned, or by the negligence of any other person or any other cause or causes. I hereby assume the sole responsibility for and agree to indemnify and save the aforementioned parties harmless from any and all loss and expenses, including legal fees, by reason of the liability imposed by law upon any of the aforementioned parties for damage and expenses. Photo/Website/E-mail Release: Signature allows MerryMac to use photos for educational purposes and website purposes unless stated otherwise and to contact student via e-mail for MerryMac activities. ***I understand the following terms and conditions: ** Yes**
Date: *


* Required

Sprayberry Square Shopping Center, 2550 Sandy Plains Road NE, Suite 365, Marietta, GA 30066 - Map
Phone: 770-579-3865 Fax: 770-579-4470 SEND A MESSAGE