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REGISTER FOR AGILITY CLASS
handler name:
your email address:	(example: name@website.com)
age (if minor):
mailing address:
city:
state:
zip:
day phone:
evening phone:
ABOUT YOUR DOG
registered name:
call name:
age:
breed:
VACCINATIONS - please bring proof of vaccinations with you to your first class
DHLPP date:
Rabies date:
Titers:
approximate height at withers (shoulders):	measure in inches
CURRENT AREAS OF TRAINING - please check all that apply
obedience
rally
other training:
TRAINING TITLES
please list all titles your dog has earned:	example: CGC, TD, NA
CLASS REGISTRATION
Which class will you be taking?
Which session would you like to take?
STATEMENT OF RESPONSIBILITY & WAIVER OF LIABILITY
I understand that agility training is an activity that is held at a private residence in the presence of other dogs and their owners/handlers. I also understand that the participation of my dog and myself in the agility training will require some physical activity on my part and on the part of my dog. I also understand that this activity will involve some running, jumping, and the use of obstacles such as tunnels, scaling planks, jumps, and tires which could result in injury to me, my dog, or to others.
I represent that I am in good health and my dog is in good health and we are both in physical condition to participate in the sport of dog agility. I further represent that my dog is friendly and not be a hazard to persons or other dogs; that I am participating at my own risk; and that I will not hold Brenda Morris, owner of the training site, or Brenda Morris' property liable for any loss, injury, illness, expense or other hardship that may arise in connection with my participation and/or my dog's participation in the activity. I further agree to assume full responsibility and liability for any and all injury or damage caused in any way by my dog(s) or myself.
I accept the Statement of Responsibility & Waiver
waiver acceptance:	no yes
PARTICIPANT'S SIGNATURE
Selecting 'yes' in this online registration form is recognized as a legal endorsement. Actual signature will be obtained before or at your first class.
p-signature acceptance:	no yes
SIGNATURE OF GUARDIAN IF PARTICIPANT IS A MINOR
g-signature acceptance:	no yes

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