SHAMROCK ACRES TRAINING CENTER

Agility Class Application

---------------------------------------------------------------------------------------------------------------------

Type of class

Beginner’s Class $75.00 ($80 as of 6/1/2010) / 7 Wks   

Class Starting Date:________________________________ Time:________________

Name: _______________________________________________________________

Email address:_________________________________________________________

Address:______________________________________________________________

City and State: _________________________________________________________ Zip:___________

Phone (home): _____________________________ (work):______________________

Breed of dog: ______________________________ Call name:___________________

Age of dog: ________________________________ Sex: ________________________ Weight:________

All dogs attending class must have received a rabies shot. Current rabies certificate #________________________

Is your dog up to date on all other shots? YES NO

Veterinarian’s Name:_______________________________ Phone:______________________

Please make check payable to: Shamrock Acres Training Center

Linda Coates

621 Indian Ridge Road

Louisville, Kentucky 40207

Questions? Call 896-8337

**Classes are held at Shamrock Acres Training Center  13917 Reamers Road, Peewee Valley,Ky