CHESAPEAKE_KENNEL_CLUB_OF_MARYLAND

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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, parvp and rabies.
NO DOG WILL BE ALLOWED IN CLASS WITHOUT PROOF OF INNOCULATIONS

Class Entered

___ Good Manners                   ___Better Manners
___ Canine Good Citizen Prep       ___Novice Obedience
___Open/Utility Obedience          ___Intro to Rally
___Rally                           ___Show Handling

Requirements for Class Participation1. 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.
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 $85 class fee 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.

				
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