Ysgol Ci Booking Form

Name *

First

Last

Address *

Email *

Telephone Number *

Data protection – Sam's K9 Academy may make names and e-mail address available to other companies. Please tick here if you prefer not to receive mailing from other dog related companies *

Yes, I want to receive mailings
No, I don’t want to receive mailings

Pictures or videos may be taken for promotional / advertising purposes do you consent to allow Pictures to be taken of you and your dog *

Yes, I consent to pictures / videos being taken
No, I don’t consent to pictures / videos being taken

Dogs Name *

Dogs Age *

Dogs Breed *

Address and Telephone Number for Vets *

Vaccination Dates *

Personal Aims (please let us know what you want to achieve from the course) *

I would like to register for the 6 week Ysgol Ci Course. I understand that the techniques used will be reward based and punishment will not be accepted during these sessions. I understand the rules regarding social distancing and agree to follow them *

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Memberships and Qualifications