2021 K9 Kup Registration

2021 K9 Kup Registration
Paws4Fun Member: *

Yes No
Team Name and Captain: *
Type "Individual" if you need to be assigned to a team.
Name: *

First Name Last Name
Phone Number: *
Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email: *
example@example.com
Emergency Contact Name: *

First Name Last Name
Emergency Contact Phone Number: *
Dog's Name: *
Breed: *
Height at Withers: *
DOB *

Month Day Year
Date
Junior Handler? *

Yes No
Dog's AAC # if applicable
Jump Height: *
How many years have you competed in K9 Kup? Include this year *
Payment Method to be used ($35 for Paws4Fun Members, $50 for Non-Members) *

e-transfer to treasurer@paws4funagility.ca - use security question "Where is K9 Kup?", with answer "paws4fun" PayPal - use the PayPal button on the Paws4Fun website at www.paws4funagility.ca Other - please describe in the comment box below
Comment

Waivers & Releases
Standard Waiver & Release

We agree that Paws4Fun Agility has the right to refuse this application for cause which the organization deems to be sufficient. In consideration of the acceptance of this application, we agree to hold Paws4Fun Agility, including its officers, directors and the premise land owner, harmless from any and all claims for injury, death, property damage or any other loss which may be alleged to have been caused by the act of our dog(s) while in or upon any club premises or adjacent grounds, and we personally assume all responsibility and liability for any such claim. We further agree to hold the aforementioned parties harmless from any claim for loss of our dog(s) by disappearance, theft, death or otherwise, and from any claim for damage or injury, be it caused or alleged to be caused by negligence of the parties aforementioned, or by the negligence of any other person, or any other cause or causes. We hereby assume the sole responsibility for and agree to indemnify the same aforementioned parties from any and all loss and expenses (including legal fees) by reason of the liability imposed by law upon any of the aforementioned parties for damage because of bodily injuries, including death at any time resulting there from, sustained by any person or persons, including ourselves or on account of damage to property, arising out of or in consequence of our participation in any club event, howsoever such injuries, death or damage to property may be caused or may have been alleged to have been caused by negligence of the aforementioned parties or any of their employees or agents, or any other person.
COVID-19 Pandemic Waiver & Release

I attest that I will enter any Paws4Fun Agility Club property only if, to the best of my knowledge, in the 14 days prior to entering:

- I have not had COVID-19, or symptoms of that virus
- I have not been in contact with anyone who has had COIVD-19 or
symptoms of that virus
- I have not travelled outside of Canada
- I have not been in contact with anyone who has travelled outside of Canada
in the past 14 days.

I have read and will follow the Paws4Fun COVID-19 Pandemic Rules at the Paws4Fun website at https://www.paws4funagility.ca/covid-19-pandemic-rules

I will follow the municipal, provincial and federal guidelines for COVID-19.

I will comply with any changes of the Paws4Fun Agility Club or government COVID-19 guidelines.

I agree to participate at my own risk in relation to COVID-19. I do not hold Paws4Fun Agility Club or its volunteers, coordinators, instructors, judges or board members responsible for contracting COVID-19.

This waiver applies from date of signing until December 31, 2021.

I will advise Paws4Fun Agility if there are any changes to my health, or those I have been in contact with, as related to COVID-19 within 14 days of my having been at a Paws4Fun Agility Club property.
By entering my name here I acknowledge that I have read, and I agree to, the "Standard Waiver & Release" and the "COVID-19 Pandemic Waiver & Release" above *

First Name Last Name
Date

Month Day Year
Date
Should be Empty:

2021 K9 Kup Registration

Waivers & Releases