CHESAPEAKE KENNEL CLUB OF MARYLAND by 67C94P6

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									                   CHESAPEAKE KENNEL CLUB OF MARYLAND, INC.
                                   CLASS REGISTRATION FORM

     PLEASE FILL OUT ALL SECTIONS OF THIS FORM, READ AND SIGN THE TRAINING
                 AGREEMENT, AND SEND THE APPROPRIATE FEES TO

                                  Dorothea George, Training Director
                                      Chesapeake Kennel Club
                                         1140 Hillendale Way
                                     Prince Frederick, MD 20678

                                       Please Print Clearly
Owner/Handler Name _____________________________________________________

Telephone # __________________ Email ____________________________________

Address


City, State, Zip

Dog's Name_______________________________ Breed _________________________

Has dog shown any signs of aggression toward people?              Yes No
Has dog shown any signs of aggression toward other dogs?          Yes No

Has dog had any previous training? If so, please describe.

Have you (owner/handler) ever trained a dog before? Please describe


Note: Your dog should have received vaccinations against distemper, hepatitis, parvo and rabies.
NO DOG WILL BE ALLOWED IN CLASS WITHOUT PROOF OF INNOCULATIONS

Class Entered

____ Good Manners                     ____ Better Manners              ____Puppy Kindergarten
____ Canine Good Citizen Prep         ____ Novice Obedience
____ Open/Utility Obedience           ____ Intro to Rally
____ Rally                            ____ Show Handling

Requirements for Class Participation: 1. Clean up after your own dogs both inside and outside
the building. Your continued use of the training facilities is contingent upon maintaining proper
cleanliness of the area. 2. Do not leave children unattended. Children must be supervised at all
times. 3. Treat dogs kindly and with respect. The Chesapeake Kennel Club subscribes to the use
of kind, motivational training methods. Harsh treatment of dogs will not be tolerated.


                                                                                       Revl (09/06/11)
Training Agreement

I, the undersigned, in consideration of the enrollment for obedience training and handling classes
being given by The Chesapeake Kennel Club of Maryland, Inc., I do hereby agree that I release
and waive any right that I may have in law to recover medical payments, property damages, or
bodily injury damages for any liability, regardless of cost, provided that liability is due to
ordinary negligence ( this release does not contemplate wanton, willful or malicious conduct) as
a result of any injury I may sustain from any other dog, my own dog or dogs, or other property
belonging to me, within the limits of Chesapeake Kennel Club, Inc. headquarters or training area
within Calvert County, Maryland.

I further agree that I hereby release and waive any right I may have at law to hold the
Chesapeake Kennel Club, Inc. and/or the owner of the premises liable for any injury which may
occur to me or my dog, dogs, or other property, provided that this injury or damage is due to
ordinary circumstances of negligence.

I further agree that I am assuming the risk of participating in obedience training/handling classes
where there are other dogs whose temperament is unknown to me, that I assume full
responsibility for any injury which may occur to me, my dog, dogs or other property as a result
of such participation this obedience training/handling class, and in the event an injury occurs to
me or to my dog, dogs or property or any damages would ordinarily be due me, that I waive any
right that I may have to institute any suit or proceedings to recover therefore. I have read and am
fully aware that this contract constitutes waiver and release of any and all liability as a result of
any injury to me, my dog, dogs or other property. I hereby certify that I am over 18 years of age,
am sober and of sound and understanding mind.

Owner/Handler Signature _________________________________________ Date

Please return this completed form, signed and dated with the class fee, as shown on the web site,
to the Training Director. Unless otherwise noted, advance registration is required for all classes

Space will not be reserved for you or your dog until payment is received by Chesapeake
Kennel Club of Maryland, Inc. Drop-ins are not permitted. Requests for refunds must be
submitted in writing after the first class.




                                                                                               Rev! (09/06/11)

								
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