| Name:_____________________________________ | ||
| Adress:___________________________________ | City:____________ | Zip:____________ |
| Home Phone:________________________ | Cell:____________ | Wk:____________ |
| Email:______________________________ | ||
| Dog’s Name:_________________________ | ||
| Breed:______________________________ | Age:____________ | Sex:___________ |
| Spayed or Neutered: Yes No (circle one) | ||
| Please list the class you are signing up for: | ||
| Class type _________________________ | ||
| Day and time _______________________ | Start Date________ | |
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. General Agreement: I (we) agree to hold the owners, their contract labor/employees, club members, and volunteers harmless from any claim for loss or injury which may be alleged to have been caused directly or indirectly to any person or things by the act of my dog(s) while in or upon training center premises or grounds or near any entrance thereto, and I (we) further agree to hold the aforementioned parties harmless from any claim for loss of this dog by disappearance, theft, death, or otherwise, and from any claim for damage or injury to the dog, whether such loss, disappearance, theft, or damage, or injury, be caused or alleged to be caused by negligence of the parties aforementioned or negligence of any other person or any other cause or causes. I (we) hereby assume the sole responsibility for and agree to indemnify and save the aforementioned parties harmless from any and all loss and expense (including legal fees) by reason of the liability imposed by law upon any of the aforementioned parties for damage because of bodily injuries, including death as anytime resulting there from, sustained by any person or persons, including myself (ourselves) or on account of damage to property, arising out of or in consequence of my (our) use of this premises, howsoever such injuries, death, damage to property may be caused, and whether or not the same have been caused or may have been alleged to have been caused by negligence of the aforementioned parties or any of their employees, or agents, or any other person. | ||
| Signature: _________________________________________________ | Date: ____________________ | |