Thurs. 7:30pm - Novice Coursework (Agility) Registration Form

Novice Coursework (Agility) is a class for dogs who have taken previous agility classes and are confident on all full height contact obstacles and can drive forward through the weave poles (guide wires may still be needed)

Name^*

Name

Address

Phone Number^*

Phone Number

Email^*

Enter email again^*

Name of Dog^*

Name of Dog

Breed of Dog^*

Breed of Dog

Age of Dog^*

Age of Dog

Sex of Dog^*

Male
Female

Sex of Dog

Previous Classes

List classes previously taken

Behavioral Concerns

List any behavioral concerns that you have

Bite History

Yes or No. If yes, please explain.

Please bring current vaccination records to your first class. Rabies vaccination not required for puppies under 16 weeks. Vaccinations are current until the following dates:

DHPP

Vaccination is current until the following date

Rabies

Vaccination is current until the following date

Terms and Conditions^*

I hereby acknowledge and agree that any injury or damage inflicted by any dog owned or trained by me at any Winnegamie Dog Club, Inc. training class is my responsibility and shall not be the responsibility of the dog club or result in any liability to the club, its instructors or assistant instructors. I further acknowledge and agree that no other club member, instructor, or any other person of the Winnegamie Dog Club, Inc. shall be responsible or liable for injury or damage to any person, or for the loss of or injury to my property. I fully understand that the Winnegamie Dog Club and its members and instructors accept and assume no responsibility for the action of the animals being trained by them, which may result in liability. I agree to observe and be bound by the obedience training rules aforementioned by the Winnegamie Dog Club, Inc. and hereby acknowledge and accept receipt of the Training Regulations.

I agree

IMPORTANT INFORMATION – PLEASE READ AND SIGN BELOW

Membership Status^*

Non Member
WDC Member
WDC Active Member

Class Registration Fee

Select a payment method^*

Pay Offline

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Thurs. 7:30pm - Novice Coursework (Agility) Registration Form

Winnegamie Dog Club

Membership

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