Class Registration - American K9 country

Class Registration Form

Class/Workshop Registration Form

Owner's Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone/Mobile

Dog's Name

Dog's Breed

Dog's Age

Proof of Vaccines

I understand that I must provide current, up-to-date vaccination information to Week #1 of Class for: Rabies, Distemper/Parvo & Kennel Cough. Note: Vaccines must be AGE Appropriate- if your pup is under the age of Six-Months they might not have all required vaccines due to the vast array of differing vaccination protocols. This is OK! Bring what you have. This information must be on Veterinary Letterhead. Rescue Organizations are NOT adequate proof of vaccines.

Initial Below

Date of Initials

How long have you owned this dog?

Describe any previous training:

Describe what you hope to accomplish:

Class Name

Day of the Week

Date / Time

Release and agreement to hold harmless and indemnify, and assumption of risk.

I understand that attendance at a dog obedience/training class is not without risk to me, members of my family, guests, or my dog, because some of the dogs to which I will be exposed may be difficult to control am may be the cause of injury even when handled with the greatest amount of care. I agree to assume the risk of injury to me or my dog.

I hereby release American K9 Country, its employees, officers, instructors, members and agents from any and all liability of any nature, for injury or damages which I or my dog may suffer, arising from the action of the training organization, its employees, officers, members, and agents or any cause whatsoever including specially, but without limitation, any injury while attending any training session, or any other function of the training organization, or while on the training grounds or the surrounding area thereto.

In Consideration of and as inducement to the acceptance of my application for training membership by this training organization, I hereby agree to indemnify and hold harmless this training organization, its employees, officers, members, and agents from any and all claims, or claims by any member of any family or any other person accompanying me to any training session or function to the training organization, or while on the grounds or the surrounding area thereto as a result of any action by any dog, including my own, or any action by employees, officers, members or agents of the training organization including any action by the instructors, or by employees, officers, members, and agents from the training organization.

Note: All signatories must be 18 years of age or have parent or legal guardian signature.

Date of Signature

Owner's Signature

Sign Here

Handler's Signature

Sign Here

Name of Handler