Detroit Dog Obedience School

BASIC/SUB-NOVICE OBEDIENCE CLASS

REGISTRATION AND RELEASE FORMS

**ABOUT THE OWNER:**
Owner's Name:
Address:
Telephone #: Home:
Work:
How did you learn of this class?
Age of children to train this dog:
Is this you first dog?	Yes No
Have you owned this breed before?	Yes No
Have you trained in basic obedience before?	Yes No
Do you intend to compete in obedience trials?	Yes No
What would you like to learn from this class?
Do you have specific problems you need to resolve?

**ABOUT THE DOG**
Name:
Age:		Breed:
Color:		Weight:
Sex:		Neutered/Spayed
Date of Birth:
Veterinarian
Veterinarian's telephone:
Date of most recent distemper vaccination:
Date of most recent rabies vaccination:
Date of most recent parvo vaccination:
Date of most recent bordetella vaccination :
Date of most recent corona vaccination:
Date of most recent fecal examination:

This dog is in good physical health, is free of vermin and skin disease, is free of internal parasites, and has been appropriately vaccinated.
I hereby certify that the above information is accurate.
Name: Date:
Class Preferred:

ASSUMPTION TO HOLD HARMLESS WAIVER AND ASSUMPTION OF RISK

I understand that att4endance at a dog obedience training class is not without risk to myself, members of my family, guests who may attend, or my dog, because some of the dogs to which we will be exposed may be difficult to control and may be the cause of injury, even when handled with the greatest care.

I hereby waive any and all rights or claims for damages arising form injuries rec3ived while involved with group activities at Belle Creek Kennels, from injury incidental to the conduct of the activities of the class and transportation to or from the premises and release Belle Creek Kennels, its employees, officers, members, trainers, and agents from any liability of any nature, for injury which I, my family, guests, or my dog may suffer, including, but not limited to any injury or damage resulting from the action of any dog or person, and I expressly assume the risk of such damage or injury while attending any training session, or any function at Belle Creek Kennels or while on the training grounds or the surrounding area thereto, or injury incidental to the conduct of the activities of the class and transportation to or from the premises.

In consideration of and as inducement to the acceptance of my application for training, I hereby agree to indemnify and hold harmless Belle Creek Kennels, its employees, officers, trainers, members, and agents from any and all claims, or claims by any other person accompanying me to any training session or function at Belle Creek Kennels, or while on the grounds or the surrounding area thereto as a result of any action of any dog, including my own, or any person.

Name: Date: