Registration

Registration Form

New Payment Option of Credit or Debit Card
Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Please enter a valid phone number.
Email*
Emergency Contact*
Contact Phone Number*
Please enter a valid phone number.
Instructor*
Class Name*
Class Date*

MonthDayYear
Payments

Payments must be made by Paypal, Zelle or Check before the start of class

Credit or Debit card payments made through Clover are no longer and option.

Zelle payment: jtdczelle@gmail.com Please put the Class Name as the reason

PayPal address: jtdczelle@gmail.com Please put the Class Name as the What's it for? If paying by PayPal, please add $3.00 to cover the fee.

Check Payment: Made payable to Jupiter Tequesta Dog Club and given to your instructor. Please put the Class Name in the Memo
Cost Information
Amount Paid*
How will you be paying*
Dog Call Name*
Class and Jump Height
How old is your dog
How long have you owned it
Breed
Gender

NeuteredSpayedIntact MaleIntact Female
Behavior

Does your dog guard foodDoes your dog guard toysDoes your dog guard youDoes your dog lunge at people or dogs
What do you want to accomplish in this class
View Terms and Conditions
Terms and Conditions

The safety of all participants is our first priority. We reserve the right to refuse further participation and will refund all or a portion of the registration fee at our discretion. By signing below, you certify that all information provided is accurate.

It is the responsibility of JTDC Instructors to keep their class participants in a safe environment. If the instructor deems that a dog is aggressive or a threat to any of the participants and/or their dogs, the instructor has the sole of discretion to excuse them. The handler and dog are precluded from participation in any future JTDC Classes unless the Board of Directors and instructor deems otherwise.

I recognize that attendance in any dog training class is not without risk to me, my dog, members of my family or guests who may attend. In exchange for my ability to participate in class, I hereby release Jupiter Tequesta Dog Club, Inc., its members, its agents as well as Florida Atlantic University, its employees, representatives and Board members from any and all loss or liability of any kind which I or my dog may suffer, including but not limited to any personal injury or property. I expressly assume the risk of such damage or injury while attending any training session or other function of the Jupiter Tequesta Dog Club, Inc. or while on the training grounds or surrounding premises.

I further agree to indemnify and hold harmless the Jupiter Tequesta Dog Club, Inc. (JTDC), its members, agents, instructors, speakers, volunteers and assistants, Florida Atlantic University, its employees, representatives and Board members for any and all loss, liability, damages, expenses, including attorney fees, and claims by any member of my family or other person who accompanies me to any training session or function of the Club, or my dog, while on the grounds and surrounding premises from any incident that occurs before, during or after the class or event. I expressly assume the risk of such damage or injury while attending a training session or while on the grounds or surrounding premises.
Signature*

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Class and Dog Information fields are no longer in use but there is data in the table that I didn't want deleted and if you delete the field it deletes that data

classdateinput is a text field passed to the form by url. It is converted to date format and put in the Class Date field
classdateinput
Dog Information

NeuteredSpayedMaleFemaleTemperament issue
Class

Nose Work (McPartland classes must be paid by zelle or paypal and applications competed online)Nose Games (Audit or Class)Down/Stay/Leave-itFETCH (Payment must be paid by zelle or paypal and application completed online)Scent Work (Contact Lauren Walsh for payment and registration)
Class Limit
Class Full
Class ID
Class Full Message

🚫 This class is full. Please contact instructor.
Should be Empty:

Registration Form

Class Full Message

🚫 This class is full. Please contact instructor.