Class Enrollment Form

Workshop Enrollment Form

Complete the information below.
Your Name

First Name Last Name
Your E-mail
Phone Number

Area Code Phone Number
Your Address

Street Address

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Dogs Name
Age
Breed
Gender
Where did you hear about us?
Is your dog current on vaccinations according to your veterinarian's recommendations?
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By signing up for this workshop or any other activities, you agree to the following liability release:
I am aware of the risks from handling animals: property damage or injury to myself, to my animal(s) or to members of my family or friends. In consideration of being permitted to enroll in the workshop, I do assume full responsibility for any actions of the dog I am enrolling and agree to hold harmless and indemnify any person associated with Canine Training Adventures, LLC or property owner Connie DeBusschere. I also understand that participating in this workshop is not without risk to me or my dog. I hereby agree to hold harmless all instructors and agents of Canine Training Adventures, LLC, and property owner Connie DeBusschere, from any and all claim of injury or damage which I or my dog may suffer while participating.
I have read and agree to the above Liability Waiver and that the above information provided is true.
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Farm Dog Workshop $ 75.00
Farm Dog Workshop Nov 14th 10 am to 1:30

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Workshop Enrollment Form