Las Vegas Odor Recognition Test Entry and Waiver of Liability & Informed Consent
Friday, November 14, 2025, 6:00 pm - 10:30 pm
National Association of Canine Scent Work, LLC®
Handler's NACSW Member Number
*
Handler Last Name
*
Handler First Name
*
Dog's NACSW Registration Number
*
Dog's Call Name
*
Breed(s)
*
Handler's Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email Address
*
example@example.com
Phone Number where you can be easily reached
*
-
Area Code
Phone Number
Emergency Contact
*
First Name
Last Name
Emergency Contact Phone Number
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-
Area Code
Phone Number
I agree (check box)
*
I understand that the behavior of dogs cannot be guaranteed. I also understand that the behavior of domestic animals is sometimes unpredictable and that some domestic animals are capable of inflicting serious personal injury or death, as well as extensive property damage. Knowing the risks I agree to assume ALL those risks including, but not limited to; assuming the financial responsibility of any possible litigation arising from any incident in which I may be involved. I release, indemnify, and hold harmless Amy Herot, Jill-Marie O’Brien, K9 Nose Work®, National Association of Canine Scent Work, LLC®, imPETus Animal Training, Holistic Hounds LLC, Veronica Selco and their Employees, Officers, Directors, Agents, or Contractors from any and all damages or personal injury. Any incident involving myself, the location, or those pets or actions of other participants and spectators will be my sole responsibility and I assume all financial liability and will also assume all and any financial costs associated with my actions.
I agree (check box)
*
In addition to the above, I understand that participating in this event, even as a volunteer or spectator holds some risk. My dog and I may be exposed to challenging, treacherous or unstable footing and accept all possible risks associated with participating or observing any type of detection style training or competition. I agree to hold harmless Amy Herot, Jill-Marie O’Brien, K9 Nose Work®, National Association of Canine Scent Work, LLC®, imPETus Animal Training, Holistic Hounds LLC, Veronica Selco and their Employees, Officers, Directors, Agents, or Contractors including, but not limited to, the event location’s agents or owner and to accept responsibility for all litigation and financial obligations arising from any unforeseen event in which I may be involved.
I agree (check box)
*
In addition to the above, I acknowledge that my pet is in good health and is able to participate at this event with other dogs and people. My dog(s) is up to date with vaccination schedule as determined by local ordinance and my veterinarian. I release, indemnify and hold harmless Amy Herot, Jill-Marie O’Brien, K9 Nose Work®, National Association of Canine Scent Work, LLC®, imPETus Animal Training, Holistic Hounds LLC, Veronica Selco and any and all volunteers, agents or contractors, including those agents of training facilities we use, from all damages or injury.
I agree (check box)
*
In addition to the above, I understand that participating in this event, I represent and affirm that to the best of my knowledge and belief: (1) I do not have COVID-19 nor am I waiting for test results; (2) I have not been tested and found positive for COVID-19 or if I have tested positive for COVID-19, I certify that I have been released by government officials and/or health care providers to resume normal activity without limit; (3) I have not during the past 14 days experienced symptoms associated with COVID-19 including fever, coughing, or shortness of breath; and (4) I have not within the past 14 days, to the best of my knowledge and belief, been in contact with or exposed to any known carrier of COVID-19. I understand the risks of contracting or being exposed to COVID-19 associated with my attendance at a training session. I agree to waive, release, indemnify, and hold harmless Amy Herot, Jill-Marie O’Brien, K9 Nose Work®, National Association of Canine Scent Work, LLC®, imPETus Animal Training, Holistic Hounds LLC, Veronica Selco and their Employees, Officers, Directors, Agents, or Contractors, including facilities we use, from any and all damages or personal injury.
I agree (check box)
*
In addition to the above, Any incident involving myself, the location, or other pets or actions of other participants and spectators will be my sole responsibility and I assume all financial liability and will also assume all and any financial costs associated with my actions. If I am to bring another family member to assist me, I affirm and take full responsibility for their health and well-being. Iunderstand the risks of contracting or being exposed to COVID-19 associated with my attendance at a training session. I agree to waive, release, indemnify, and hold harmless Amy Herot, Jill-Marie O’Brien, K9 Nose Work®, National Association of Canine Scent Work, LLC®, imPETus Animal Training, Holistic Hounds LLC, Veronica Selco and their Employees, Officers, Directors, Agents, or Contractors, including facilities we use, from any and all damages or personal injury.
Agreement
I have read, understand and agree to the above:
Signature (use mouse or finger)
*
Today's date
*
Minor's name
Parent's name
Parental consent:
I am the lawful parent and/or legal guardian of the above named minor. I acknowledge that I have read and understand this Liability Waiver and that I and the above named minor will be bound by said Liability Waiver.
Parent signature
My Selections
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BIRCH
$
38.00
ANISE
$
38.00
CLOVE
$
38.00
Total
$
0.00
Click HERE To Submit Entry Form
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