KKTC SHORT COURSE EXPRESSION OF INTEREST

FOUNDATION OBEDIENCE COURSE
Expression of Interest

By completing this form you are expressing an interest in undertaking a 4 week beginner obedience course and will be added to the waiting list. Classes run with a minimum of 4 and a maximum of 8 dogs. We will contact you when the next space is available. Fees include club membership until 30th June. After completing the Foundation Obedience course you will be able to to continue your training in regular weekly classes. Payment in full will be required before the course commences.
Your Details

This information is for the use of Kyeamba Kennel & Training Club (KKTC) and will be used internally for the purpose of your membership application only. KKTC does not disclose member information to third parties other than DogsNSW.
Short Course you wish to undertake
Are you currently a member of KKTC?
Name*

First NameLast Name
Facebook Name (if different to above)

First NameLast Name
E-mail*
example@example.com
Phone Number:*
Format: (000) 000-0000.
Address:

Street Address

Street Address Line 2

CityState

Post code
Date of Birth

DayMonthYear
Date
DogsNSW Member Number
If Applicable
Emergency Contact*

First NameLast Name
Emergency Phone*
Format: (000) 000-0000.
Add Family Member
Family Member Name

First NameLast Name
Family Member Email
example@example.com
Family Member Phone
Format: (000) 000-0000.
Family Member Facebook Name

First NameLast Name
Parental supervision is required for children under the age of 16 years.

At times KKTC may photograph and/or video members and their dogs for use on the club website, social media and other promotional material or educational purposes. Do you agree to multimedia of you and/or your dog being used by KKTC for promotional and/or educational purposes?*

I agreeI do not agree
Terms and Conditions
1. The use of check chains, pronged collars, electric collars and other tools deemed aversive by KKTC are in conflict with the club’s philosophy and not permitted.

2. KKTC recommends all preventative health care measures are kept up to date for all dogs including, but not limited to, core vaccinations, kennel cough vaccination, internal and external parasites. It is your sole responsibility to ensure your dogs are protected from preventable diseases.

3. You understand the behaviour of domestic animals cannot be guaranteed, is sometimes unpredictable, and that some domestic animals are capable of inflicting serious personal injury or death as well as extensive property damage.

4. You agree to assume all risks including, but not limited to, the financial responsibility of any possible litigation arising from any incident which you may be involved.

5. Any incident involving yourself, the location, or those pets or actions of other participants and spectators will be your sole responsibility.

6. You assume all financial liability including any financial costs associated with your actions.

By submitting this form you automatically release, indemnify and hold harmless Kyeamba Kennel and Training Club Inc, it's Instructors, Volunteers and agents, from any and all damages.
*

I have read, understood, and accepted the Terms and Conditions.
Please verify that you are human*
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FOUNDATION OBEDIENCE COURSE

Expression of Interest

Your Details

Your Dog

Terms and Conditions