HIGH DESERT OBEDIENCE CLUB
CLASS APPLICATION
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CLASS: __Puppy __ Novice __Clicker Tricks __ Rally __Advanced Obed. __Competition Obed. OTHER_________ |
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Name_________________________________ Address ______________________________________
City _____________________________ Zip __________ Phone____________________________
Briefly state what you hope to accomplish in this class ________________________________________________
How Did You Hear About Our Classes? __Newspaper Ad __Internet __Friend __Vet
Have you trained other dogs? _______What Breeds? ____________________________________________
To what level have you trained a dog? ____________________ Titles earned _________________________
PLEASE Read and Sign Waiver on Back |
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Dog’s Name __________________________________________ Age ____________ Sex__________
Breed ___________________________________ Color __________________ Spayed/Neutered? ______
IMMUNIZATION INFORMATION -
Dates of Rabies _________ Distemper/DHL-P _________ Parvo _________ Other__________
Name
of Veterinarian or Clinic
___________________________________________________ |
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Would you like to be added to our Events Email/Postal List? c Yes Email Address _____________________________________________________ |
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CLUB DISCOUNTS- (Discounts apply ONLY to Puppy PreSchool & Novice Classes)
O Senior Citizen (55 yrs +) O 2nd Family Dog in Same Class O Lanc. Animal Shelter O Active Military O Service Dog O Repeat (same dog/trainer/handler) O Club Member |
CLUB USE ONLY - Location___________ Check # ___________ Trainer_____________ Cash $ ___________ Proof of Shots ____ App. taken by __________ |
AGREEMENT TO HOLD HARMLESS, WAIVER AND ASSUMPTION OF RISK
I understand that attendance of a dog obedience training class is not without risk to myself, members of my family or guests who may attend, or my dog, because some of the dogs to which I will be exposed to may be difficult and may be the cause of injury even when handled with the greatest amount of care.
I hereby, waive and release the HIGH DESERT OBEDIENCE CLUB, INC., hereinafter referred to as the “Training Organization”, it’s employees, officers, members and agents from any and all liability of any nature for injury or damage resulting from the action of any dog, and I expressly assume the risk of such damage or injury while attending any training session, or any other function of this Training Organization, or while on the training grounds or the surrounding area thereto.
In consideration of and as inducement to the acceptance of my application for training membership by this Training Organization, I hereby agree to indemnify and hold harmless this Training Organization, it’s employees, officers, members, agents and facility in the City of Lancaster and Palmdale, from any and all claims, or claims by any member or function to the Training Organization, or while on the grounds or the surrounds area thereto as a result of any action by any dog, including my own dog.
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Signature of Owner or Authorized Agent Date
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Print Name
________________________________________________________________________________
Address (if different from front page) City
___________________________________ _____________________________________
Telephone (if different from front page) Emergency # (REQUIRED)
Minors are welcome and encouraged to attend and participate in HIGH DESERT OBEDIENCE CLUB’S obedience classes. However, due to stringent laws and insurance requirements all minors attending these classes must be accompanied by a parent, guardian or responsible adult appointed by the parents. Parent or Guardian must remain at the class site.
I have read and understand the above and agree to its terms.
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Signature of Parent or Guardian Date