ALL BREED OBEDIENCE TRAINING CLUB
REGISTRATION INFORMATION
-Please print legibly-
OWNER'S NAME_________________________________________________________________
ADDRESS_______________________________________________________________________
CITY ___________________________________________________ZIP_____________________
HOME TELEPHONE _________________________________________
E-MAIL _________________________________________________________________________
HANDLER’S NAME ________________________________________ AGE (if minor)_________
DOG’S CALLING NAME ___________________________________ AGE__________________
BREED __________________________________________________ SEX _________________
HAS THE DOG BEEN VACCINATED AGAINST: Rabies _________
Distemper _____ Parvo ________ Hepatitis _____ Corona________
Any known physical defects? __________________________________________________________
How did you learn of the Club?__________________________________________________________
Did you adopt/rescue from a shelter? Please give
shelter name: __________________________________
STATEMENT OF RESPONSIBILITY AND WAIVER OF LIABILITY
In consideration of the acceptance of me by the ALL BREED OBEDIENCE TRAINING CLUB as a member of its dog training classes of instruction, I/we, the undersigned, hereby agree to abide by the rules and regulations of the ALL BREED OBEDIENCE TRAINING CLUB and to be solely and severally responsible for any and all damages or injuries resulting from any act by me or my dog. Further, I will not hold the ALL BREED OBEDIENCE TRAINING CLUB nor any of its members liable in any damage(s) or injury(s) to my dog or me.
Signed this __________ day of ________________________, 2008.
Signature _____________________________________________
Date Paid _________ Amount $__________ Check ____ Cash ____
(Please make out check to ABOTC)