Dog Sports at Kim’s

Instruction by Joan Meyer

APPLICATION FOR AGILITY CLASS

Please enter the class name, time of class, and start date below. There is a limit of ten dogs per class.

Class Name:_________________________________________________________________________

Class meets at (time):_________________________________________

Class Start Date: _________________________________________

COST OF CLASS is $120.00 FOR SIX-WEEK SESSION.

FEES MUST BE RECEIVED before application will be accepted for a reservation.

Location of training: Dog Sports at Kim’s 1951 Townsley Lane Caseyville, IL 62232

NAME:____________________________________________________________________________

ADDRESS: _________________________________________CITY:_______________________________

STATE/ZIP _____________________________________HOME PHONE: ___________________________

WORK or CELL PHONE: __________________________E-MAIL __________________________________

BREED OF DOG: ________________________DOG'S CALL NAME: _____________________

DOG’S AGE: _______DOG’S JUMP HEIGHT ______ VACCINATION DATE: _______________________

Agreement to Hold Harmless Waiver & Assumption of Risk

I understand that attendance of a Dog Agility Training Class is not without risk to myself, members of my family or guests who may attend, or my dog, because some of the dogs to which I will be exposed may be difficult to control and may be the cause of injury even when handled with the greatest amount of care.

I hereby waive and release Triune Canine Training Center, Dog Sports at Kim’s, and their agents from any and all liability of any nature, for injury or damage which I or my dog may suffer, including, specifically, but without limitation to, any injury or damage resulting from the action of any dog, and I expressly assume the risk of such damage or injury while attending any training session or while on the training grounds or the surrounding area thereto.

In consideration of and as inducement to the acceptance of my application for Dog Agility Training with Triune Canine Training Center, I hereby agree to indemnify and hold harmless Triune Canine Training Center and Dog Sports at Kim’s and their agents from any and all claims, or claims by any member of any family or any other person accompanying me to any training session or while on the grounds or the surrounding area thereto as a result of any action by any dog, including my own.

If because of riots, civil disturbances, or other acts beyond the control of Triune Canine Training Center or Dog Sports at Kim’s it is impossible to complete classes, no refund of training fees will be made. There will be a $15 charge on all returned checks. No equipment is to be used except that approved by the instructor.

Signature_________________________________________________Date:________________________

Class Fee is due before a reservation for class will be made and is NON-REFUNDABLE.

Please make check payable to TRIUNE CANINE TRAINING CENTER

Mail to Joan Meyer at 1210 Hamlin Court, O’Fallon, Il 62269.

For more information call (785) 865-6670.