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.