THRIVE and Power'd Up Pet First Aid and CPR Registration Form

THRIVE AND POWER'D UP HOST: Pet First Aid and CPR Clinics

PLEASE DO NOT BRING YOUR DOGS OR OTHER PETS! THRIVE IS PROVIDING MANNEQUINS FOR TRAINING. OUR INSTRUCTORS WILL BE LVT'S FROM PERINTON VETERINARY HOSPITAL, KATHY SMITH AND RHEA WEIMER.
Full Name
First Name*
Last Name*
Email Address*
Cell Phone #*
Workshops

Please check the workshops you wish to attend
Sat Feb 10 am

Working Spot $30 (12 working teams, 9am - 11am)
Sat Feb 10 pm

Working Spot $30 (12 working teams, 1pm - 3pm)
TOTAL
Final Payment

Payment by CASH or CHECK is required upon confirmation of your registration. In the event that you withdraw from the clinic, Power'd Up will attempt to fill the vacancy. If we are able to fill the spot, you will be refunded your cost less a $10 handling fee. If we are unable to fill the spot, no refund will be granted.
Waiver

Owner agrees to release POWER'D UP AGILITY LLC/THRIVE from all liability for any loss, damage or injury to persons. POWER'D UP AGILITY LLC is fully insured through The Hartford (Sportsman Insurance Agency). By clicking submit on this form, you fully agree to this waiver of liability.
Should be Empty:

THRIVE AND POWER'D UP HOST: Pet First Aid and CPR Clinics