Academy of Dog Training & Agility

CLUB MEMBERSHIP AGREEMENT

Address Line 2:

City:

Phone (Home):

Email Address:

Phone (Cell 1):

Dog's Name:

Color:

Breed:

Club Membership Fee:

MI:

~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ALL APPLICATIONS MUST BE SIGNED ~ ~ ~ ~ ~ ~ ~ ~ ~ ~

State:

Zip Code:

Door codes and/or keys will be revoked for non-payment or flagrant violation of the safty regulations.

Use the facilities as often as you like, except when a formal class or special event, seminar, or clinic is scheduled.

Make sure you have a cell phone with you in case you have an emergency. There is no real phone in the building.

Bitches in season are not allowed in the building.

Paid membership includes your next set of lessons free.

Report any condition that does not complement handler and dog safety to 302-588-4636.

How did you hear about us?:

MY DOG WAS VACCINATED AGAINST RABIES BY:

I acknowledge that my dog(s) is/are up to date on all health inoculations including rabies, (if adult) DHLP and PARVO. I further acknowledge that THE ACADEMYOF DOG TRAINING AND AGILITY WILL NOT BE HELD RESPONSIBLE FOR ANY DAMAGES AND/OR LOSS OF PROPERTY DURING FACILITY USE OR CLASSES. I hold The Academy of Dog Training and Agility harmless for any accident and all liability, costs, and expenses arising as a result of this activity, including but not limited to, loss/damage to property, personal/ bodily injury or death, to any person, including yourself and your dog(s).

Last Name:

Address Line 1:

Phone (Cell 2):

Veterinarian's Name:

Date Given:

Tag #:

(Parent or legal guardian, Please sign full name in blue ink after printing, if applicant is a minor)

Digital Signature:

Mail registration form with check to: The Academy of Dog Training and Agility

1845 Old Cooches Bridge Road

Newark, DE 19702

302-588-4636

Make checks payable to: The Academy of Dog Training and Agility

Print this form before mailing, so that you can send it in with your check!

Date:

Dog's Age:

Digital Signature:

Written Signature:

______________________________________________________________________

(Parent or legal guardian, Please type full name here, if applicant is a minor)

First Name:

Phone (Work):

Date:

Written Signature:

(Applicant, please sign full name in blue ink here after printing)

(Applicant, please type full name here)

(Payable at time of sign-up)

(Includes next set of lessons free)

Membership issued to qualified obedience and agility people only. Annual membership must be pre-paid unless other arrangements have been made.

I have read and agree to comply with all of the above regulations.

Membership Accepted:

_________________________________________________

(Only Academy of Dog Training and Agility certifying signature here in blue ink)

Date:

____________________

Membership From:

____________________

To:

Call Name:

Send email to WEBMASTER@ACADEMYOFDOGTRAINING.COM

with questions or comments about this web site.