Intro to Agility Registration Form

Intro to Agility Registration

Please fill out the form carefully for registration
Dog Guardian's Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student E-mail*
example@example.com
Mobile Number*
Phone Number
Dog's name:*
Dog's breed:*
Dog's age:*
Dog's sex:*

FemaleFemale spayedMaleMale neutered
Where did you adopt/acquire your dog from?*
Is your dog current on Rabies (4 months and older); Distemper (DHPP); and Bordetella (Kennel Cough) vaccinations (required to attend class)?*
Proof of vaccination is required to attend classes.
Does your dog have any aggression issues (will need instructor approval to attend class)?*
Where did you hear about Spot On Dog Training Center?*
Classes*

Intro to Agility: Saturday - 11:00am: February 14th (Last class is March 21st) (6 classes)
* There will be no payment refunds, unless either a doctor's or veterinarian's note is provided, if you withdraw from a class with less than two weeks notice, or if you withdraw after the class has started.
Liability Waiver:

I, the undersigned, confirm that I am the owner or person responsible for the dog(s) brought into Brandi Moore's (Manners & Moore Dog Training) classes and Spot-On Dog Training Center. I understand that Brandi Moore, Manners & Moore Dog Training, and Spot-On Dog Training Center are not responsible for any injuries or illnesses incurred by myself, my dependents, my guests or my dog(s) as a result of participation in this class and I waive and release any such claims resulting from participation in this class.

I understand that Brandi Moore, Manners & Moore Dog Training, and Spot-On Dog Training Center are not responsible for any damages caused by my dog(s) to persons, animals or to any property and are not responsible for any injuries or illnesses incurred by myself, my dependents, my guests or to my dog(s) as a result of participation in this class. I agree to indemnify and hold harmless Brandi Moore, Manners & Moore Dog Training, and Spot-On Dog Training Center and its owners and employees from any such claims.

I agree that payment in full is due at the time of registration. I understand that there will be no payment refunds, unless either a doctor's or veterinarian's note is provided, if I withdraw from a class with less than two weeks notice, or if I withdraw after the class has started.
Signature (please use mouse to sign)*

Clear
Additional Comments
Classes*
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Intro to Agility: Saturday - 11:00am: February 14th (Last class is March 21st) (6 classes)
$200.00 Quantity
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$0.00

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