RETURN COMPLETED REGISTRATION TO: 

Delaware Humane Association, 701 A Street, Wilmington, DE 19801

Phone: (302) 571-0111 / Fax (302) 571-8173

or e-mail: dehumanedogtraining@yahoo.com

           

INDOOR CLASSES HELD AT:

Playtime Doggie Daycare & Pet Salon

62 Albe Drive, Ste. A, Newark, DE 19702

Phone: (302) 368-3100

 

OBEDIENCE CLASS REGISTRATION FORM

 

Guardian’s Name: ______________________________________________________________

 

Address: ______________________________________________________________________

City: ___________________State: ____ Zip:____________E-mail:_______________________

 

Phone: (h) ____________________________(w)______________________________________

 

I am registering for the following class: Puppy ____Adult ___ Other ______ Session _________

Date class starts: _______________________ Day / Time of Class:_______________________

 

Dog’s Name: _____________________________________ Breed: _______________________

Age at beginning of class: _________________ Adopted from DHA? Yes ______ No________

 

Sex: M ___ F ___       Spayed / Neutered? Yes ___ No _____ Today’s Date:________________

 

WAIVER AND RELEASE

(MUST BE SIGNED)

            I understand that participating in Delaware Humane Association’s Dog Obedience Classes includes an element of risk for both my dog and myself. I agree to abide by any decision of an instructor relative to the ability of my dog and myself to complete the course safely. I further assume any and all risks associated with participating in this course, including but not limited to, illness, falls, contact with other participants and dogs, and surface conditions, all risks being understood and appreciated by me. I also affirm that the dog that I will be participating with has current vaccinations appropriate to his/her age. I agree to abide by all rules of the course.

 

            Having read this waiver and knowing these fact, and in consideration of the acceptance of my registration, I hereby for myself and my heirs, executors and administrators, or anyone else who might make a claim on my behalf, covenant not to sue, and agree to waive, release and discharge the Delaware Humane Association and/or Playtime Doggie Daycare & Pet Salon and their volunteers and employees in any way assisting or connected with this course from any claims or liability of any kind whatsoever arising out of my participation in this course, even though the liability may arise out of negligence or carelessness on the part of the persons or parties named in this waiver.

 

            I also understand that Delaware Humane Association and/or Playtime Doggie Daycare & Pet Salon may subsequently use, for publicity or promotional purposes, my name or pictures of me or my pet without liability or obligation to me.                                                                                 

 

_____________________________________________             _____________________________

Enrollee’s signature                                                                 Enrollee’s printed name

 

Used with permission of Denver Dumb Friends League, Denver, CO