Instructions:
§
NOTE: Pre-registration is
required because class sizes are limited
§
Use a separate form for each dog (form may be photocopied)
§
Make check or money order
payable to Wenatchee Kennel Club, Inc
§
DO NOT send mail directly to
the training center.
§
Mail completed form with
payment to Wenatchee Kennel Club, Inc,
P. O. Box 805, Wenatchee WA 98807
Owner’s
Name______________________________________________________________________________________
Mailing
Address_________________________________________________________________
City_________________________________________________
Zip______________________
Phone
(evening)__________________________ (daytime)______________________________
E-mail address?
________________________________________________________________
Dog’s call
name__________________________ Breed
____________________________________________________
Male or Female?________________
Spayed/Neutered?__________________ Birthdate__________________________
Date of last vaccinations: Rabies______________
Other___________________________________________________
Briefly describe any previous training this
dog has:_________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
Any behavior
problems?______________________________________________________________________________
___________________________________________________________________________________________
Have you taken a class
with us before?_________________ If not, how or where did you find out
about these classes?
___________________________________________________________________________________________
I wish to sign
this dog up for the following classes:
1.
________________________________________ Day_______________
Time________________ $______________
2.
________________________________________ Day_______________
Time________________ $______________
Please read and
sign Agreement below
AGREEMENT
In consideration of the acceptance of the dog described
on this form, and of the opportunity to have this dog participate in training
sessions, I agree to hold Wenatchee Kennel Club, Inc. and its board of
directors, officers, instructors, members, agents and employees, and the owners
of the premises upon which the training is held, harmless from any claim for
loss or injury which may be alleged to have been caused directly or indirectly
to any person or thing by the act of this dog while in or upon the training
premises or grounds or near any entrance thereto, and I personally assume all
responsibility and liability for any such claim; and I further agree to hold the
aforementioned parties harmless from any claim for loss of this dog by
disappearance, theft, death or otherwise, and from any claim for damage or
injury to the dog, whether such loss, disappearance, theft, damage or injury be
caused or alleged to be caused by the negligence of the parties aforementioned,
or by the negligence of any other person, or any other cause or causes. I
hereby assume the sole responsibility for and agree to indemnify and save the
aforementioned parties harmless from any and all loss and expense (including
legal fees) by reason of the liability imposed by law upon any of the
aforementioned parties from damage because of bodily injuries, including death
at any time resulting therefrom, sustained by any person or persons, including
myself or on account of damage to property, arising out of or in consequence of
my participation in this training, howsoever such injuries, death or damage to
property may be caused, and whether or not the same may have been caused or may
have been alleged to have been caused by negligence of the aforementioned
parties or any of their associates, employees, agents, or any other persons. In
consideration of the acceptance of this entry, I agree to abide by the rules and
guidelines set forth by Wenatchee Kennel Club, Inc. in effect at the time of
this training, and by any additional rules and guidelines that may be set forth
by the aforementioned parties. I certify that the dog participating in this
training is not a hazard to persons or other dogs and that the information I
have supplied on this form is true. I further agree to be bound by the above
Agreement.
Signed_____________________________________________
Date________________________________
Signed______________________________________________
Date________________________________
Anything you want to
add?