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GREEN ACRES TRAINING CLASS REGISTRATION FORMSwitch to PDF (printable) view | Get a Free PDF File Reader
Green Acres Training Class Registration Form for 2010 (C)Phone: ____________________________ Email: ______________________________________ City:_____________________________________________________ Zip: ____________________ Dog’s Name: _______________________________ Breed: ________________________________ Dog’s Date Of Birth: _____/_____/______ Sex:____________ Spayed/Neutered Color:__________ Veterinarian: ______________________________________________________________________
Refunds for withdrawals from class must be requested at least 14 days prior to the first class.
Credit Card# ____________________________________________ Exp. Date: ________________ Signature: _____________________________________________________________________ Office Use Only: ( ) Paid ( ) Training Database ( ) K9 Coordinator ( ) Confirmation Letter Green Acres Waiver, Assumption of Risk and Agreement to Hold Harmless I understand that attendance at a private or group dog training session 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 (we) will be exposed may be difficult to control and may be the cause of injury even when handled with the greatest of care. In consideration of, and as an inducement to, the acceptance of my registration for a training session or sessions, I agree to indemnify and hold harmless, and hereby release Green Acres Kennel Shop, its employees, owners or agents from any and all liability of any nature, for injury or damage which I, my family or guests or my dog I also understand that the degree to which a dog is successfully trained is a function of the interest, commitment, and cooperation of the owner. I acknowledge and agree that there is no guarantee that my dog will achieve the desired level of training despite the best efforts of the instructor. I understand that I may withdraw from a class and receive a refund, minus a $15 handling fee, up until 14 days before my first class. After this time my registration fee becomes non-refundable. I also understand that after starting a class Green Acres staff may determine a group class is not suitable for my dog, in which case Green I understand that photographs and video may be taken of me and my dog during classes and allow Green Acres to use those images in training and promotional materials. All members of your family who will be handling your dog during training sessions must sign below. Name _______________________________________________________________ Date _____/_____/_____ Signature _________________________________________________________________________________ Name _______________________________________________________________ Date _____/_____/_____ Signature _________________________________________________________________________________ Name _______________________________________________________________ Date _____/_____/_____ Signature _________________________________________________________________________________ Name _______________________________________________________________ Date _____/_____/_____ Signature _________________________________________________________________________________
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Last Updated November 21, 2009
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