Class Registration

Register for Classes

Name *

First

Last

Phone Number *

Email *

Location *

Select a Class *

Dog Name *

Age *

Sex *

Male Female

Spayed/Neutered *

Yes No Unsure

Breed *

Please note: Proof of vaccination must be brought to the first day of class. You can also email us a copy prior to class as well.

Payment Method *

If paying via check please send to:
Lisa Berkenstock
c/o Rockledge Veterinary Clinic
401 Huntingdon Pike
Rockledge, PA 19046

If paying via PayPal you will be prompted to make a payment after completing the form:
Payments are made to bstock7@verizon.net

Address *

Line 1

Line 2

City

State

Zip Code

Country

Liability Agreement:
I AGREE TO RELEASE Lisa Berkenstock, Dana Ebbecke, Krista Gabarro Davis, Julie McLaughlin, Lynn Brearey, Colleen Campbell, Katarina Cruz, Rockledge Veterinary Clinic and staff, North Penn Animal Hospital and staff, Huntingdon Valley Presbyterian Church and staff, Animal Hospital of Warwick and staff, Richboro Veterinary Hospital and staff, Rau Animal Hospital and staff, and Colmar Veterinary Hospital and staff from any liability for personal injury, injury to pet or property damage that I may suffer or sustain by reason of the use of the hospital, grounds, equipment, facilities, or appointments therein, or as a result of my attendance thereof.

Choose One *

I agree. I disagree

Submit