Decoy Workshop with Jerry Bradshaw March 3-5, 2010
The Ohio Law Enforcement K9 Association (OLEKA) will be hosting a Police Canine Decoy Workshop instructed by Jerry Bradshaw March 3-5, 2010 in the Cincinnati suburb of Sharonville Ohio. We will have unlimited space for OLEKA members and associate members who want to observe during this workshop. Spectators will be charged $150 for the 3 day workshop. If you are not a member or associate member and wish to attend you can visit our website to join our organization.
Jerry Bradshaw is owner of Tarheel Canine Training Inc, author of “Controlled Aggression” and numerous articles in police canine magazines. He has excellent working dog knowledge. Jerry also has a gift for teaching in a manner easy to understand and apply. Spectators should expect to learn a lot during this workshop.
Ohio Law enforcEment k9 association
“To improve K-9 use, training and confidence by forming partnerships from multi jurisdictions around the state."
Decoy Workshop featuring Jerry Bradshaw
March 3-5, 2010
Sharonville, Ohio
REGISTRATION FORM
NAME:
DEPARTMENT:
DEPARTMENT ADDRESS:
DEPARTMENT PHONE NUMBER:
DEPARTMENT FAX NUMBER:
E-MAIL ADDRESS:
K-9 NAME:BREED:
SHIRT SIZE:
3 XL 2 XL XL L M S
REGISTRATION FEE: $150OLEKA Member-Spectator
Please make checks payable to:OLEKA “Decoy Workshop”
Attn: Gerald Bemis P.O. Box 104
New Lebanon, Ohio45345
Hotel:Drury Inn & Suites
2265 East Sharon Rd.
Cincinnati, Ohio45241
(513) 771-5601
(Mention OLEKA)
SUBMIT REGISTRATION & FEES NO LATER THAN February 20, 2010
P.O. Box 104• New Lebanon, Ohio45345
Phone: 937-687-1476
Ohio Law enforcEment k9 association
“To improve K-9 use, training and confidence by forming partnerships from multi jurisdictions around the state."
Photo Release Form
During attendance of this OLEKA K9 Seminar, staff members will be taking photos for future OLEKA presentations and promotions. All photos and video will contain the utmost professionalism and will project the quality course desired by OLEKA.
By signing this form you are releasing all photos and/or video that are taken during your attendance of the OLEKA certification and further give permission for staff to use that acquired media in manners conducive to the mission of OLEKA and its promotion.
Print Name
Signature
Date
Ohio Law Enforcement K9 Association
MEMBERSHIP APPLICATION
Annual Dues: Regular $30.00 and Associate Members - $30.00 per Year
Today's Date: ______/______/______Date of Birth: _____-_____-_____
Last Name: ______First: ______MI:
Home Address: ______
City: ______State: ______Zip:
Home Phone Number: (area code) ______-______-______Email ______
Type of membershipRegular Active Associate
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Answer ALL questions.
Are You a Certified Law Enforcement Officer? Yes___ No___
If yes: State Federal Local Fire/Investigator EOD
Do you have Arrest powers?Yes___ No___
Does your Law Enforcement Employer use you and the K9? Yes___ No___
Police/Law Enforcement Agency Employed by: ______
Work Address:______
City: ______State: Zip:
Work Phone Number: (area code) ______-______-______Email ______
Position (circle one): Handler, Trainer, Other - describe: Narcotics Explosives Patrol Accelerant S&R
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Associate Member
Indicate type of Associate Out of State Law Enforcement K9 Out of State Law Enforcement non K9
In state Law Enforcement non K9 Emergency Responder
Private for hire K9 handler In State non Law Enforcement non K9
Regular Member signature sponsoring you: ______If you have no sponsor leave blank.
Regular Member - print your name here:______
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K9 Information
K-9's Name: ______Date of Birth: _____-_____-_____
Age: ______yrs. ______months Sex: M F
Breed: ______Color(s): ______
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NOTE: All personal checks that do not clear will be charged a $30.00 fee in addition to membership fee and any bank fees you may incur.
All applications are subject to background check for authenticity and integrity. By submitting this application you agree that all information is correct and truthful to the best of your knowledge.
(Applicant Signature)
Send Membership form and fees (payable OLEKA) to:
Ohio Law Enforcement K9 Association
P.O. Box 104
New Lebanon, Ohio45345
Waiver of Liability for OLEKA Decoy Workshop with Jerry Bradshaw March 3-5, 2010.
I hear by waive and relinquish the Ohio Law Enforcement K9 Association (OLEKA), Sharonville Police Department, Princeton School District, Girard Bradshaw, Tarheel Canine Training Inc., The Protection Sports Association Inc., and event organizers and associates of this event from any physical or mental injury to myself or my canine. I also agree to abide by the rules established by OLEKA and take all responsibility for myself and/or my dog’s actions while attending this event. I understand the physical nature of these workshops and relinquish any liability from the organizers or other participants of the event. My dog is in good physical condition and is up to date on all shots and vaccinations. Furthermore, I accept responsibility for any damage caused by either myself or my canine or any injury or damage caused by either myself or my canine to any person or property while attending this event.
______
Signature Date
P.O. Box 104• New Lebanon, Ohio45345
Phone: 937-687-1476