2017-2018PuppyBeginnerObedienceClassApplication-Session5

Orientation:Tuesday,May 8, 2018,7:00p.m.,atLittleRockDog TrainingClub

(PleasedonotbringyourdogtoOrientation)

ClassesStart:Sunday,May 13, 2018ClassesEnd:Saturday,June 23, 2018

Email applications to:

ProspectivestudentssubmittingApplication,Questionnaireandpaymentpriortoorientationwillreceive ane-mailorphoneconfirmation. Classesarelimitedandfillonafirstcome,firstservedbasis. PaymentmustbesubmittedwithApplicationtoreceivea classassignment.Classfeescannotbe refundedafterthe firstregularclass.

HANDLERINFORMATION
Name
Address
City, StateZip Code
Phone Numbers(Day/Night/Alternate)
CurrentMemberofLRDTC / YesNo / Handleris16 yearsoldorolder YesNo
EmailAddress:
DOGINFORMATION
Dog’sNameand Gender
Dog’sBreed
Dog’sAge and Date ofBirth
DateofCURRENTVaccinations / Rabies Distemper Parvovirus Hepatitis
***Proofofvaccinationmustbe submittedprior tothe startofthe firstclass***

Classesaresubjecttochangebasedonenrollmentandinstructoravailability.Sendin theQuestionnairewith theEnrollmentApplication.

CLASSINFORMATION
Cost / Class / Day / Time / OrderofChoice*
$53 / PuppyKindergarten* / Sunday / 3:00PM–4:00 PM
$71 / Beginner Obedience* / Sunday / 2:00 PM – 3:00 PM
$71 / Beginner Obedience* / Monday / 6:00 PM–7:00 PM
$71 / Beginner Obedience* / Tuesday / 7:00 PM–8:00 PM
$71 / Beginner Obedience* / Thursday / 10:00 AM–11:00 AM

IfrequestingafreerepeatofBeginnerObedience,pleaselistthepreviousBeginnerclasstaken(datebegun,day,time,and

Instructor):

*Classsize islimited.Pleasespecifyyourorderofchoicebyindicating“1stChoice”and“2ndChoice”in thedesignatedspaceabove.

Dogsmustbeundercontrolatalltimes.LRDTCreservestherighttoexcludefrom trainingclassesanydogthathasa knownhistoryof aggressionorexhibitsdangerousbehaviors.LRDTC alsoreservestherighttodismissfromtrainingclassanydoginclasswhobehaves aggressivelytowardpeopleorotherdogs.

INCONSIDERATIONOFTHE ACCEPTANCEOFTHISAPPLICATION,I(we)agreetoholdthisclub,itsMembers, officers,agents andany employeesoftheaforementionedparties,harmlessfromanyclaimfor loss orinjury whichmay beallegedtohave

beencauseddirectlyorindirectlytoanypersonorthing bythe actofthisdog whileinoruponthe trainingpremisesorgrounds ornearanyentrancethereto,andI(we)personallyassumeallresponsibilityandliabilityforanysuchclaim.

I(we)alsoagreeto hold theforegoingparties harmlessin theeventof injuryordamageto myself,mydog,myguests,and/or myproperty.

Signature Date

Insertinga digitalsignatureor typednameonthesignaturelineofthisform constitutesagreementandacceptance of theterms herein andislegallybindingthe same asa handwrittensignature.

MailTo: LittleRockDogTrainingClub,Attn:Classes,P.O.Box56694, Little Rock AR 72215 Email to:

ATTENTION:A confirmationemailshouldbesentwithin5daysofreceipt.Ifnotreceived,

ForLRDTCuseonly:Recv’d Paid Confirmed