| Dear Class Applicant
Congratulations on your decision to obedience train your dog. The Kennel Club of Texarkana looks forward to helping you train your pet. Below is an application that you need to fill out and return as soon as possible. Class size is limited so that we may better serve you and your pet. Classes will be filled on a first come, first served basis. Please return your application and class fee as soon as possible to ensure yourself a spot in the class. Puppy classes are $50, and adult classes are $60. The classes will start on September 8, 2008 and will be held on the Moore’s Lane Baptist Church Parking Lot . Please be sure to sign the liability waiver on the last page of the application. You will be contacted if your application is received after the classes are full. Checks will be returned if classes fill before receipt of your application. Make checks payable to: The Kennel Club of Texarkana. You must provide proof of vaccination. This is for your protection and the protection of all dogs in the class. Please attach a copy of your veterinarian’s vaccination record to your application. Rabies is required by law. Other vaccinations are important to protect the dogs from canine infectious diseases. All handlers must be 12 years of age or older. Collars and leashes will be available for purchase on the first night of classes. KCT would prefer to properly fit your pet with a quality collar and leash. Total cost for collars and leashes should not exceed $15.00. If you have any questions, please contact Jennifer Freeman at anu_kennels@yahoo.com. Please bring completed application to the first class. Thank you! THE KENNEL CLUB OF TEXARKANA APPLICATION FOR OBEDIENCE CLASSES Please circle the class you are entering: PUPPY ADULT OWNER/HANDLER INFORMATION Date:_______________ (Please print) Name_________________________________________________________________ Address_______________________________________________________________ City___________________________________State_______________zip__________ Phone___________________________ Age (if under 18)_______________________ E-mail________________________________________________________________ DOG INFORMATION Breed_________________________________________Age___________________ Call Name ____________________________________ Sex____________________ How long have you owned this dog?_______________________________________ Is this your first dog?____________________ What other breeds have you owned?________________________________________________________ Have you trained a dog before?________________________________________ VETERINARY INFORMATION Veterinarian _____________________________________phone________________ Current vaccination record attached? ___ Yes ___ No CLUB RECORD (DO NOT WRITE IN THIS SPACE) ___ Proof of vaccination ____Proper collar _____Proper leash Payment: ______check _______cash Class fee $_________ Collar _________ Leash _________ Total $________ LIABILITY WAIVER AGREEMENT TO HOLD HARMLESS/ASSUMTION OF RISK I understand that attendance at a dog obedience training class is not without risk to myself, members of my family or guests who may attend, or my dog, because some of the dogs to which I will be exposed may be difficult to control and may be the cause of injury, even when handled with the greatest amount of care. I hereby waive and release THE KENNEL CLUB OF TEXARKANA , its members, officers and agents from any and all liability of any nature, for injury, damage which I or my dog may suffer, including specifically, but without limitation, any injury or damage resulting from the action of any dog and I expressly assume the risk of such damage or injury 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 of THE KENNEL CLUB OF TEXARKANA, I hereby agree to indemnify and hold harmless THE KENNEL CLUB OF TEXARKANA , its officers, members and agents from any and all claims, or claims by any member of my family or any other person accompanying me to any training session or function of THE KENNEL CLUB OF TEXARKANA, or while on the grounds or the surrounding area thereto as a result of any action by any dog, including my own. Signature of Owner or Authorized Agent (In case of a minor, a parent or guardian must sign.) Signature:____________________________________________Date:_________ _______________________________________________________________________ Printed Name of Owner:_____________________________________________ Address____________________________________________________ City___________________________State_______________________Zip_________ |
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