BAD Class Registration Form

**PAYMENT MUST ACCOMPANY REGISTRATION FORM**

A completed form is required for EACH dog & EACH class

Winter Session fee $180 for 12 week session

(There is a $25 charge for any check returned to BAD by the bank.)

Make checks payable to Breakaway Action Dogs.

Send to: Patti Young 3612 Marguerite Ct, Mt Airy, MD 21771

NO Registration will be processed without a signed BAD Class Registration Form and Payment.

Member ______Trained w/ BAD before ______New ______

Class ______Day of Week ______Time ______

Instructors and the Training Director have the right and obligation to move dogs to appropriate classes.

Part A

Handler's Name: ______Age (if under 18): ______

Owner (if different): ______

Street Address: ______

City: ______State: ______Zip Code:______

Best Phone # you can be reached at:______

Area Code/Number

E-mail address: ______

How did you hear about us (circle one): BAD member Facebook BAD Website Veterinarian Friend Other______

(details)

Part B All dogs must be current on all vaccinations including rabies.

Dog’s Name: ______Dog's Age: ______Breed: ______

Sex ______Neutered ______Spayed ______

Has this dog, at any time, shown signs of aggression? ______

My dog was vaccinated against rabies by: Dr. ______Date: ______Tag No:______

(Not required for puppies under 4 months of age)

Agreement: I have read the rules (on back) and agree to abide by them. I understand that failure to conform to the rules can lead to my

being barred from class participation by Breakaway Action Dogs Training Director. I certify that dog(s) enrolled in this training have been

immunized against rabies (Exception for puppies under 4 months of age) and DHL. Parvo recommended. I further certify that the dog(s) are

in good health. I hold Breakaway Action Dogs, and its instructors harmless from any and all liability, costs and expenses arising as a result

of this activity, including but not limited to, injury or death of dogs, bodily injury or death to any person and damage to property of any kind.

Signature: ______Date: ______

(Parent or Legal Guardian if a junior)

CLUB USE ONLY

Session Dates: ______Paid $______Ck# ______

Club Rules

NO AGGRESSIVE DOGS WILL BE PERMITTED IN CLASSES. Dogs exhibiting aggressive

behavior, as determined by any instructor of B.A.D., Inc. may be asked to leave class. No refund will

be forth coming.

BITCHES IN SEASON WILL BE EXCUSED FROM CLASS

Bitches in season are not allowed in the building! We highly encourage owners to attend class without the dog. We view this as an important training opportunity! Owners are still given the opportunity to see what is being taught in class; many of these skills can still be practiced at home.

Use of Prong Collars

Breakaway Action Dogs does NOT allow the use of prong collars in any classes. Owners/handlers may use a prong collar to transition a dog to and from the car into the building, but it MUST be removed prior to the start of class.

Cleanup: Exercise dogs in designated area. Scoop all poop thoroughly. Preferably take all poop with

you or deposit it in outside receptacle designated for dog poop. DO NOT allow dogs to go around

landscaping.

If an accident occurs pick it up or wipe it up with cleanup items located in the training facility. Take

home EVERYTHING, feces, paper towels, plastic bags, and any other soiled items. Do NOT place

any waste materials in training facility trash cans. Owners are responsible for cleaning up after their

dogs.

Disturbances: Participants using unsafe handling, or harsh or severe corrections as determined by

the instructors of B.A.D. will not be permitted. Participants are expected to conduct themselves and

control their pets in such a way as to not interfere with training. Barking dogs that disturb training will

not be allowed.

Children: All children under 16 years of age, whether participating in a training class or not, must be accompanied and under the supervision of an adult at all times. Children are not allowed to play in

the parking lot.

Attendance: Training builds each week on previous training. Participants should attend regularly to

benefit from class. They should advise their instructor if they will be absent.

DOGS MUST BE UNDER CONTROL AT ALL TIMES

Please initial that you have read these rules ______