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Training Registration Form |
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GREEN ACRES TRAINING CLASS REGISTRATION FORMSwitch to PDF (printable) view | Get a Free PDF File Reader
NAME: ________________________________________________________________ (H)PHONE: ____________ (W)PHONE: ____________ (C)PHONE: _____________ EMAIL: ________________________________________________________________ ADDRESS:______________________________________________________________ CITY:_________________________________________________ ZIP: ____________ DOG’S NAME: _______________________ BREED: __________________________ DOGS DATE OF BIRTH: _____/_____/______ SEX:_________ SPAYED/NEUTERED: Yes No
Sign-up for Puppy Kindergarten AND Basic Manners at the same time and you will receive a $15 discount on the Basic Manners class. Add a Level 2 class at the same time and get another $25 discount. 1st Choice: DATE: _________________ TIME: _________________ 2nd Choice: DATE: _________________ TIME: _________________ VETERINARIAN: _______________________________________________________ CREDIT CARD# ___________________________________ EXP DATE: _________ SIGNATURE: ___________________________________________________________ REFUNDS FOR WITHDRAWLS FROM CLASS MUST BE REQUESTED AT LEAST 14 DAYS PRIOR TO THE FIRST CLASS. DO NOT FORGET YOUR REGISTRATION FEE and SHOT RECORDS! REMEMBER TO SIGN THE WAIVER ON THE NEXT PAGE OFFICE USE ONLY: PAID ___/___/___ DATABASE CODE: ___________ Waiver, Assumption of Risk and Agreement to Hold HarmlessI 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 may suffer, including specifically, but without limitation to, any injury or damage resulting from the action of any dog including my own, and I expressly assume the risk of any such damage or injury while attending any training session or other function of Green Acres Kennel Shop or while on property belonging to Green Acres Kennel Shop or at any other location where classes may be held. 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 $10 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 Acres will credit the remainder of my class fees for private training or behavior counseling at their current rates. 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. Anyone who will be handling your dog during training sessions must sign below. Parents must sign for minors. NAME SIGNATURE DATE _____/_____/_____ NAME SIGNATURE DATE _____/_____/_____ NAME SIGNATURE DATE _____/_____/_____
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Last Updated November 27, 2007
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