Summer Camp Registration Kids 4 K9s Please complete the following application. Each of the narrative questions must have a response. APPLICANT INFORMATION Name * First Name Last Name Date of Birth * MM DD YYYY High School * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Cell Number * (###) ### #### Ethnicity * African-American Asian Caucasian Latino Other PARENT / GUARDIAN / EMERGENCY CONTACT Name * First Name Last Name Relationship * Mother Father Grandparent Aunt Uncle Sibling Babysitter/Nanny Guardian Cell Number * (###) ### #### Email * ELEMENT OF INTEREST Please tell us why you are interested in participating in the summer program? * TRAINING-RELATED EXPERIENCE Have you had previous experience training a dog? * Yes No If you have previous experience training a dog, please describe. For example, tell us what you taught the dog to do, and tell us how you taught them to do it. Describe what training tools you utilized, and what training strategies you used. LOGISTICS T-Shirt size? * Adult Small Adult Medium Adult Large Adult X-Large CAUTION NOTE: We use peanut butter throughout the facility. If you have a severe allergy to peanut butter, the shelter environment might not be suitable for you. Are you allergic to peanut butter? * Yes No Do you have physical limitation that require additional support? * Yes No Please list any general questions about the program that you would like answered during the orientation session. Thank you!
