Please print-out, read, and complete the following information carefully. Indicate the class you wish to attend, sign, date, and return this enrollment agreement along with your payment to: Cris Doss at Club K-9 Training Center, 12115 Leavitt Road, Oberlin, Ohio 44074. Please send this form before your first class. If you have any questions please contact me at 440-323-6961.
Name ____________________________________________________________
Address _________________________________________________________
City, State & Zip _______________________________________________
Home Phone _____________________ Work Phone _____________________
Email __________________________________________________________
Dog's Name ______________________ Breed ______________________
Age ____________ Male/Female Spayed/Neutered? Yes/No
Veterinarian's Name ____________________________________________
Vaccine Dates:
DHLPPCvk_________ Rabies 1yr/3yr _________ Bordetella__________
Proof of current vaccines will be required the first day of class.
I wish to enroll my dog in the following class:
Class Name _______________________ Day and Date ________________
Obedience and Agility group classes meet once a week
for 6 weeks and the cost is $95.00.
Conformation Classes are $6.00 per class per dog.
Private lesson rate varies. See Cris for Details.
By signing this enrollment form, I/we,
_________________________________________________
hereby agree to abide by the rules and regulations of Club K-9 Training
Center and Cris Doss. I/we agree to assume full responsibility for
keeping my dog under control at all times, to faithfully carry out the
recommendations of the instructors and to train my dog to the best of
my ability. In consideration of the acceptance of this application, I
agree to abide by the rules and requirements set forth. I understand
that attending class is not without risk to myself, my dog and members
of my family or guests who may attend. I/we herely agree to release and
hold harmless, Club K-9 Training Center, Cris Doss, Douds Veterinary
Hospital, and any and all associates, officers, agents, and employees,
from claim for loss or injury which may be alleged to have been caused
directly or indirectly to any person or thing by the act of this dog
while in or upon the premises or grounds or near any entrance thereto.
I/we personally assume all responsibility and liability for any such
claim; and I 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, damage, or injury, be caused or
alleged to be caused by the negligence of the Training Center or any of
the parties aforementioned, or by the negligence of any other person,
or any other cause or causes. I herby 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 at anytime resulting
therefrom, sustained by any person or persons, including myself, or on
account of damage to property, arising out of or in consequence of my
participation in the activities of this training center, howsoever such
injuries, death or damage to property may be caused, and whether or not
the same may have been caused or may be alleged to have been caused by
negilgence of the aforementioned parties or any of thir employees or
agents, or any other person.
As owner and handler, I agree to accept any and all
responsibility for my own dogs' actions.
Authorization/Signature and Date
__________________________________________________________
Amount Enclosed ___________________
Please mail payment to the address below and make checks payable to:
Cris Doss
12115 Leavitt Road
Oberlin, Ohio 44074
440/323-6961
Directions to Training Center
State Route 58, North of Oberlin
At Douds Veterinary Hospital
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