Fourth of July Hideaway
Registration Form for Fourth of July Hideaway
Name *
Your answer
Phone Number *
Your answer
E-mail *
Your answer
Mailing Address *
Your answer
Is there another family member attending? If so, please indicate their name(s). If this is a child, please contact us directly for additional information.
Your answer
Do you or any of your family have allergies or special needs that we need to be aware of? If so please describe below. *
Your answer
What is your dog's name? *
Your answer
What is your dog's age, gender, breed and weight? *
Your answer
Does your dog have any allergies or medical conditions we need to be aware of? If so please describe. *
Your answer
If you are bringing a second dog, what is his/her name?
Your answer
What is your second dog's age, gender, breed and weight?
Your answer
Does your second dog have any allergies or medical conditions we need to be aware of? If so please describe.
Your answer
Please add the same information as the questions above for any other dogs you will be bringing.
Your answer
Please check all of the following that pertain to your dog: *
Required
I understand and agree that if my dog is showing an excessive amount of anxiety due to being in a new location, or is showing behavior that is not safe, the Synergy staff reserve the right to ask you and your dog to leave the event. There will be no refund in this situation. *
Required
i understand that because of the advance preparations needed for this event, the registration fee is non-refundable. *
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Would you like to informed of future events at Synergy Behavior Solutions? *
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