Fundamentals for Success Seminar - Working Spot Registration
Featuring Facilitators Ben Lepinski and Ann Quigley
Name
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First Name
Last Name
Phone Number
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-
Area Code
Phone Number
E-mail
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example@example.com
Dog name(s):
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Dog age(s):
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What sport(s) do you participate in with your dog(s)?
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Have you titled any of your dog(s)? If yes, please detail any title(s) achieved:
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Please detail any OBEDIENCE skills/concepts/behaviors that you feel you and your dog struggle with as a team:
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Please detail any PROTECTION skills/concepts/behaviors that you and your dog struggle with as a team:
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As state law requires and for insurance purposes, your dog must be current on their rabies vaccination prior to their participation in the seminar.
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I understand and verify that my dog is UTD on rabies
RELEASE: It is the understanding that the above handler / dog team are participating in this seminar AT THEIR OWN RISK. I understand that serious accidents can and do occur during dog training, competitions and other dog related events / activities. I am assuming all risk, liabilities and responsibilities and will hold harmless The Discerning Dog LLC, Lepinski K9 Services LLC, their agents, partners, employees, sponsors, and facilitators from ANY AND ALL liability arising from this dog-related event and training. I also agree to hold harmless any of the above mentioned from any property damage, theft, death or personal injury to my dog or myself. I also agree to have complete control over myself and my dog(s) at all times. By signing this entry form I acknowledge that I have read and understand this waiver. There will be no refunds given to any handler that has been ejected from this event for any reason. In addition, by signing this release I give consent to any representative of The Discerning Dog LLC and Lepinski K9 Services LLC to take pictures of events and any activities surrounding the events. Further by submitting this form, I release any rights to the sale, posting or distribution of any pictures taken and waive any right to remuneration or compensation for any picture taken or sold of the events in question.
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I understand
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