Course Registration Form

If you or your dog are sick - please do not come to class.

Student Name

First NameLast Name

Additional Family Members Attending Name(s)

Class Title

Class Start Date

Date

Class Start Time

Hour Minutes

AM/PM Option

Waitlist

Please add us to the WAITLIST for this class if full

Dog's Name

Dog's Breed

Dog's Age

Student Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Student E-mail

example@example.com

Mobile Number

Phone Number

Additional Comments

Payment: Payments are accepted via Zelle using 703-346-1375 and email mistydownsfarm@gmail.com or check payable to Misty Denny unless otherwise stated at the time of registration. All payments are due at the beginning of the first class.

Cancellation Policy I understand if Misty Downs needs to cancel a class, we will add an extra day to the session to make up for the cancelled class. Unfortunately, we are unable to offer make-up sessions if you miss due to your own schedule. You may make arrangements to arrive early to the next session to receive instruction on what was missed.

WAIVER ASSUMPTION OF RISK AND AGREEMENT TO HOLD HARMLESS I understand that attendance of a dog obedience/fitness training class is not without risk to me, members of my family, guests who may attend, or my dog. Some of the dogs to which I (we) 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 Misty Downs Animal Wellness & Training, its trainers, owners and agents from any and all liabilities of any nature, for injury or damage which I or my dog may suffer including specifically, but not without limitation, any injury or damage resulting from the action of any dog from here forth. I expressly assume the risk of any such damage or injury while attending any training session or other function of the facility, 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 in the obedience training class, I hereby agree to indemnify and hold harmless this facility, its employees, owners and agents from any claims, or claims by any member of my family or any other person accompanying me to any training session or surrounding area thereto as a result of any action by any dog, including my own.

This farm has horses on the premises and the following applies: NOTICE OF INHERENT RISKS WITH HORSES – Please Do Not feed, pet or let your dog’s interact with the horses: I understand Equines have the propensity to behave in ways that may result in injury, harm or death to persons on or around the equine; have unpredictable reactions to such things as sounds, sudden movement and unfamiliar objects, persons or other animals; are susceptible to certain hazards such as surface or subsurface conditions, collisions with other equines or objects; propensities include kicking, biting, stamping, stumbling, rearing, and others; tack equipment can fail resulting in falling or loss of control; and activities have the potential of a participant to act in a negligent manner that may contribute to injury to the participant or others, such as failing to maintain control over the equine or not acting within the participant’s ability. Equine activities are INHERENTLY DANGEROUS.

By completing this form I further certify that my dog is current on vaccinations and /or titers required by the state of Virginia.

Referred By

Student Class Registration Form