Clever K9 Obedience w/ Ann Marie Scripko

AgilityRegistration and Release form

Name:______

Address:______

City, State, Zip:______

Phone:______Email:______

Dog’s Call Name:______

Dog’ Breed:______

Dog’s Age:______Has your dog ever bitten anyone?:______

IF yes, please explain:______

Vaccines or Titer current?:______

Has this dog ever taking Obedience/Agility classes:______

IF yes, Where and what levels:______

CLASS INFORMATION : Cost $125 for6 One hour classes

Mondays Outdoors in Jackson Adv. Beginner agility 9am (limit 8) Beginners agility 10am (limit 8)

Wednesday Outdoors in Jackson Beginner Agility 7pm (limit 8)

Thursdays Outdoors in Jackson Adv. Beginner Agility 6pm ( limit 8) Open 7pm (limit 8) Novice 8:30pm (limit of 8)

Class:______

Dog’s Name:______Class Time:______

Class:______

Dog’s Name:______Class Time:______

Class:______

Dog’s Name:______Class Time:______

Make checks payable to CleverK9 Dog Obedience or Ann Marie Scripko. Mail or hand to Ann Marie Scripko 279 Jackson Pines Road, Jackson NJ 08527. Contact Ann with questions at or 732-901-4166

All classes must pre-register, No spots will be held without payment.. If there are not enough dogs to fill a class, you will be given the option of a refund or move to a different class. There are no refunds once the first class begins. If classes are canceled by Ann due to bad weather etc. there will be a makeup class, no refunds.. If you miss a class, for any reason, you can make up the class by attending another class of similar level your dog is working at. There are no refunds or private lessons to makeup for classes you miss..

You must fill out the release form on the back of this form.

Clever K9 Obedience Release Form

I, ______, understand that attendance of a dog training session 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 (we) 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 understand that the use of dog training equipment and the use of the Training facility are not without risk to myself, members of my family or guests who may attend, or my dog, because dog training requires physical movement on both my and the dog’s part.

I hereby waive and release the property owners, Joe Mosner and Golden Grange Kennels, Ann Marie Scripko, Michael Scripko and Clever K9 Obedience, and any instructors, or employees or family members from any and all liability of any nature or damage which my family, guests, I or my dog may suffer, including specifically, but not without limitation, any injury, or damage resulting from the action of any dog or use of equipment.

I expressly assume the risk of any such damage or injury while attending training sessions, or while on the training grounds or the surrounding area thereto. In consideration of and as inducement to the acceptance of my application for training at this facility, I hereby agree to indemnify and hold harmless the property owners, Joe Mosner and Golden Grange Kennels , Ann Marie Scripko, Michael Scripko and Clever K9 Obedience, and any instructors, or employees or family members from any and all claims, loss and expenses , including legal fees, or claims by any member of my family or any other person accompanying me to any training session, by reason of liability imposed by law upon the aforementioned party for the damage because of bodily injuries at any time resulting there from, sustained by the aforementioned party or may be alleged to have caused by negligence of the aforementioned party or any of the person.

Signature:______

(or signature of legal Guardian if handler is under the age of 18)

Print Name:______

Date:______

New Bad Weather Policy

Because of the large number of students to contact for classes ... I will no longer be able to call with class cancellations. If class is cancelleddue to weather conditions,I will post an email to the Clever K9 Yahoo group only by approximately 4pmMondaysand Thursdays. I will not email directly to each email, I will not be able to call individually . Please make sure you join the group or call. I will also post a message on my Answering machine if classes are cancelled. This will be posted by approximately 4pm. Class status will also be posted on the website.

It will be your responsibility to check your email and call 732-901-4166 to check on the status of class during bad weather. Remember if weather seems questionable, to check. Decisions will be based on The conditions at Golden Grange, Agility ring in Jackson and the surrounding Central Jersey area. This can be very different from where you live. Please make a habit of checking before you leave.

Typical Guidelines:

Outdoors in Jackson

-no class if Below 32 degrees

-no class if over 90 or heat index is over 90

-no class if snow or ice on ground

-no class if Thunder and lightening. (light rain, still have class)

Indoors at Golden Grange

-no class if road conditions or building conditions are not safe due to snow, ice, or severe thunderstorms

Thank you and feel free to contact me with any questions or if you need an application sent to you.

Ann

732-901-4166 or my cell 848-525-8298

To Join the Yahoo Group go to: