SEATTLE AGILITY CENTER Agility - Obedience Mailing Address: Seattle Agility Center PO Box 290 Maple Valley, WA 98038 (425) 271-5433 CLASS REGISTRATION FORM Name of Owner_____________________________Others Participating_____________________ Street Address_______________________________City____________ Zip Code____________ Day Phone___________________Evening Phone__________________E-Mail__________________ Dog's Call Name________________________Breed(s)______________________Age___________ Previous Training__________________________________________________________________ Specific Behavior Problems_________________________________________________________ Where did you hear about us? (Please be specific)__________________________________ ***Please provide information on current vaccinations in space on back of this form. Please list class, date and time desired...First and Second Choice FIRST CHOICE SECOND CHOICE Class ______________________________ ________________________________ Day of Week ______________________________ ________________________________ Start Date ______________________________ ________________________________ Start Time ______________________________ ________________________________ Amount Enclosed $_____________________(Make checks payable to Seattle Agility Center) I understand and agree to the following: To indemnify and hold harmless Doug Ricks, Diana Harris, and Seattle Agility Center, its owners, board of directors, officers, agents, employees, instructors, and staff members, from any and all claims, demands, actions, causes of action or liability of any kind whatsoever, for death, personal injury or property damage in any way proximately caused by ourselves, our family members, our friends and/or any animal belonging to, or brought onto the premises by myself or any member of my family or my assigns. I further agree, on behalf of myself, my family and my assigns, to assume complete and sole responsibility for any and all actions of any animal belonging to, or brought onto the premises by myself, any member of my family or my agents or assigns. Signed_____________________________________________________Date_________________________ Please print: First and Last Name______________________________________________________ I agree to the following facility guidelines: 1. Dogs must be on leash AT ALL TIMES. 2. POTTY YOUR DOG ONLY IN THE DESIGNATED AREA AND CLEAN UP AFTER YOUR DOG. There will be a $10.00 fine for anyone who does not follow this basic courtesy. 3. Do not leave dogs in the car. If you are attending class with multiple dogs, come prepared to crate inside the training building. There is plenty of space for your crate. 4. Do not arrive more than 15 minutes early for your class to avoid parking entry-exit problems. In addition, I understand and agree to the following: No dogs aggressive toward people or other dogs are allowed in any of the classes. If you need clarification on this point, speak to one of the instructors BEFORE registering your dog. Keep your dog on leash and six feet from other dogs unless otherwise directed by your instructor. Keep your dog quiet at all times by following your instructor's recommendations. We can help with noisy behaviors. Be responsible for all children and family members attending class. Children under 16 are welcome, but must be accompanied by an adult. Young children must have an adult with them during class. Vaccinate your dog as required: Puppies normally should not begin class until they have received their second set of puppy shots prior to the first class they attend. This is usually between 9-12 weeks. Dogs over 1 year of age must receive annual boosters or titer test and Rabies boosters every 3 years. Bordatella (kennel cough) is recommended but not required. Please note date of last vaccinations: DPP(3 way puppy shot)_______Rabies_______Bordatella________