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Class Registration Form Return completed registration form to: Starved Rock Kennel Club Inc. Class Registration PO Box 396 - Ottawa, IL 61350 Call (815)434-4886 |
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[Please Print] Shots OK ? Date
How did you hear about us?
Name:
Address:
City/State/Zip
Phone Email
I am registering for the following class:
Puppy Class Novice Class Beginning Advanced
Intermed. Advanced Conformation Handling (Drop IN)
Advanced Punch Card Conformation Punch Card
Dog’s Call name Breed
Age at beginning of class Dog’s Sex Spayed/neutered? Yes No
Has your dog bitten or snapped at anyone?
Has your dog ever been aggressive toward other dogs?
Class Fees enclosed $Checks made payable to SRKC)
Deposit $ Misc. Equipment etc.$ Total Amount.$
Cash Check #
IMPORTANT: Your deposit should be received at least one week prior to the first class to ensure your placement. For your dog’s protection, current vaccination proof is MANDATORY. Please bring proof of shots to the first class. SRKC may withdraw privileges from any person whose dog is deemed vicious or unruly by the instructor. There are NO REFUNDS after classes start.
Waiver of Liability: I have read the Policies and Training Guidelines and this application and understand them, and agree to abide by them. For consideration of the acceptance of this registration and the said fees, I agree not to hold SRKC and the trainers liable for any loss or injury, for whatever cause, which may occur upon or within the vicinity of the training facility to 1) said dog, myself or anyone handling or training my dog on my behalf and 2 ) to any person or thing which may be alleged to have been caused by my dog, myself or any person handling or training said dog on my behalf. I also understand that any child handler 10 and older must be accompanied by an adult.
________________________________ Signed Date _________________
________________________________Accepted Date _________________
For Class Schedules call (815)434-4886 or go online at www.starvedrockkennelclub.com