SpokesDog -- Pet Therapy 101 Registration

Pet Therapy 101 Registration for Seminar & Team Evaluation

Upon electronic receipt of the completed on line registration a space in class will be temporarily held for your team(s). You will receive an email invoice indicating that we have received your on line registration. Per instructions on that invoice you will be asked to send payment to the address listed. Once we receive your fee by regular mail, your seminar/evaluation date will be confirmed by email. You are not confirmed until you receive email notification. Your email confirmation will include as an attachment, directions and other information.
Pet Therapy 101 includes both the seminar and team evaluation. Should you wish to only register for the team evaluation there is a box to check below. Teams registering only for the evaluation will be evaluated after those teams who have attended the seminar complete their team evaluations.
Space is limited and fills quickly so we advise to register early.
Fill out completely (* indicates REQUIRED FILEDS), read the agreement below, initial and SUBMIT at the bottom of this form.

Handler Information

First Name*

Last Name*

Address 1*

Address 2

City*

State*

Zip*

Day Phone*

Evening Phone*

Cell Phone (if applicable)

Email*

EVALUATION ONLY
($30 per evaluation) Check here if Team Evaluation ONLY is required

Pet Information

# of Pets (1 handler/Pet)
$100 for one handler/one Pet
$30 per additional Pet in house/same handler
$30 for Evaluation Only teams (no seminar)

Addtional Family Members
$65 for second handler in house/same Pet
$65 for second handler in house/different Pet

Pet's Name(s)*

Pet's Age(s)*

Species*

Breed*

Vet*

Vet's Phone*

Pet's most recent Vet exam date*

Class Date 1st Choice See Dates/Times Page

Class Date 2nd Choice

WAIVER:
I indemnify and hold Diane Rich Dog Training, LLC, any of their contractors or volunteers, Cascade Plaza/Vista, Diane Rich and Delta Society harmless from and against all claims, losses, liabilities and damage to persons or property, governmental charges or fines and attorney's fees arising out of the acts or omissions of this workshop/class including, but not limited to: interactions with instructor(s), attendees, volunteers, and/or animals, screening or demonstrations involving my companion animal, or transportation of my companion animal to or from the workshop or within this same site.
For the safety and comfort of other handlers, other dogs, instructors, facility staff and residents if your dog barks uncontrollably, is disturbing other people or pets, or shows aggression to any person or dog you may be asked to take your dog out of the facility. Sorry, no refunds. Should this occur, you may leave your dog in the car, if weather permits and enjoy the balance of the seminar and observe the evaluations.
Requirements for Class Participation and Team Evaluation in Pet Therapy 101:

Purchase and review the home study workbook course from Delta Society www.deltasociety.org. Bring book to class.

Bring proof of rabies. Tag is not proof. A Vet receipt is acceptable.

Bring completed handler’s questionnaire, signed policies and procedures form and indemnity form

Dog must be leashed at all times via a 4-6 foot fabric or leather leash, be groomed and parasite/flea free. Retractable, flexi-leads, metal leashes are not allowed anywhere on facility grounds.

You may wish to bring dog mat for your dog's comfort as the floor is not carpeted. Bring poop bags, water/bowl for dog, r grooming tool. Delta Society requires you to bring a pet brush or grooming tool for one of the test exercises

Flat or rolled buckle or snap closure leather or fabric collars, Martingale or head halter collars only. Collars not allowed: prong/pinch, choke, no pull harness.

Pet treats may not be used for your pet's performance/motivation during the evaluation. However, a pet treat is included in one of the exercises. You may bring your own treats for that one exercise.

Dog must be a minimum of 12 months old (please inquire as to minimum ages for other species)

Dog needs to know basic obedience i.e. sit, stay, down, come, walk on a loose lead

Pet must be quiet and under control at all times which are skills needed as a Delta volunteer. Control means housebroken, not pulling you around, not jumping on pets or people, not vocalizing, relaxed and use to other dogs and people.

Team Evaluation Only (follows the seminar)

Bring proof of rabies per requirements listed above

Bring completed handler’s questionnaire, signed policies and procedures form

Dog needs to be wearing Delta approved collar and on proper leash (requirement listed above applies)

You may wish to bring a special treat for your pet for the one exercise. Otherwise treats not allowed

Space and time are limited and our classes are usually full so register early.
Refund Policy: Sorry, no refunds within 14 days of class date or if asked to leave the class or any reason. We apologize, but there are no free makeup seminars or evaluations if you cancel or need to reschedule within the 14 days of any confirmed seminar/evaluation or just don't show up.
If you can't attend the workshop for which you were confirmed you will need to re-register and we will do our best to get you into the next available workshop.
* Cancellation fee of $25.00 for Pet Therapy 101 if cancelled 14 days or less from class date. Cancellation fee of $10 for evaluation o only dates if cancelled 14 days or less from confirmed date.
*Although this has not happened to date we have not had to reschedule any class. But, we do reserve the right to reschedule workshop dates due to facility conflicts, illness or group size. You will be offered alternative dates.

Initials*

By initialing I have read, understood, agree to above and am 18 years of age or older.

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