All Breed Training Performance & Fun Day
June 17, 2023
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
-
Area Code
Phone Number
Dog's Call Name
*
What Breed is Your dog?
*
Please Select
Jack Russell Terrier
Other Terrier
Other Breed
How tall is your dog at the withers (where shoulder meets neck)?
*
Please Select
Below 10" / 24.5 cm
10"-12.5" / 24.5-32 cm
12.5-15"/ 32-38 cm
15"-20" / 38 -50 cm
20" or above / 50+ cm
How Old is your dog in Years?
Please Select
Puppy (4-12 months)
Adult (1-5 years)
Veteran (6-9 years)
Senior (10 + years)
Which Events do you wish to enter?
*
Ball Retrieval
Barn Ratting
Brush Hunt
Lure Coursing
Rumble Tunnel
Go to Ground
Agility Try It
Dock Diving Try It
I hereby enter the above at my own risk and I hereby engage to be responsible for any injury, loss or damages that may occur to, or be caused by, any animals, vehicles, or trappings exhibited by me, and I further agree to be absolutely responsible for the physical condition of any animal under my control or ownership and will release, indemnify and save harmless Reidell Farms and the JRTCC from any damage, expense and/or liability arising out of, or resulting from, any act of the Exhibitor or their agents or employees. I hereby certify that my dog(s) are free from contagious disease.
*
Yes
No
In consideration of being allowed to participate at this event sponsored by the Jack Russell Terrier Club of Canada and related events and activities, the undersigned acknowledges, appreciates, and agrees that: 1. Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and, 2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, 3. I willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases. If, however, I observe and any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and, 4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS (the Jack Russell Terrier Club of Canada and Reidell Farms) their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IF FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. I agree to the terms and conditions (covid waiver)
*
Yes
No
Name(s) of Participants under the age of 18, if any.
FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT THE TIME OF REGISTRATION)This is to certify that I, as parent/guardian, with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations for protection against communicable diseases. Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees for any and all liabilities incident to my minor child’s/ward’s presence or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent provided by law.
Yes
No
There are no participants under age 18 accompanying me.
Signature
Is this the first dog you are registering?
Yes -- I will send $40 to treasurer@jrtcc.ca via e-transfer for my first dog, password Funday
No -- I will send an additional $20 to treasurer@jrtcc.ca via e-transfer for this dog, password Funday
Submit
Submit
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