Hot Springs National Park Kennel Club (HSNPKC)
8 weeks of Obedience Classes
Please Print
Name of Owner______Phone(work)______
Street Address______(home)______
City______State______Zip______
Name of person training dog______Age (if under 18)____(must be at least 15)
e-mail – (for reminders only) ______
Name of Dog______Veterinarian______
Breed______Required Vaccinations Dates DHL___/___/___
Age of Dog ______Parvovirus___/___/___ Date of Birth______Rabies___/___/___
If you administer your dog’s vaccinations your must show proof (package labels, receipts etc.)
We also recommend a kennel cough vaccination (dog cold) due to the number of dogs coming in contact with each other.
State any problems (may use back ifneeded)______
All classes $75.00 (Check one) – 8 weeks of classes on Tuesday nights
Hot Springs National Park Community College- Gym
6pm____PUPPY(Must be at least 10weeks-first 2 vaccines) 7pm____PUPPY(Must be at least 10weeks-first 2 vaccines)
6pm BASIC_____ over 6 months 7pm Basic____ over 6 months
Time preference due to availability! Please send back application in a timely manner, Thanks!
Waiver. Assumption of Risk and Agreement to Hold Harmless
I understand that attendance of a dog obedience training class 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 hereby waive and release the HSNPKC and the National Park Community College, the employees, officers, members and agents from any liability of any nature, for injury or damage which I or my dog may suffer, including specifically, but without limitation, any injury or damage resulting from the action of any dog, and I expressly assume the risk of such damage or injury while attending any training session or other function at the HSNPKC or while on the training grounds or the surrounding areas thereto. In consideration of and as inducement to the acceptance of my application for training in the obedience training class, I hereby agree to indemnify and hold harmless the HSNPKC and the National Park Community College, their employees, officers, members and agents from any and all claims, or claims by any member of my family or any other persons accompanying me to any training session or function of the HSNPKC or while on the grounds or the surrounding area thereto as a result of any action by my dog, including my own.
Signature, Owner or Authorized Agent ______Date______
For HSNPKC only; Instr.______Shots______Paid______ck/cash Class______
Keep this part Please keep this bottom part of form for your records! Keep this part
Make checks payable to Hot Springs National Park Kennel Club and mail with this form to:
Joan Rosemier
210 Holland Lane
Hot Springs, AR. 71913
Application and check must be received by HSNPKC prior to orientation night.
Remember you are not enrolled until check and application is received!
Bring proof of vaccinationorientation night.
Class sizes are limited and fill quickly.
Applications received after classes are full will be returned.
Orientation for all classes is Feb. 21, 2017 - 7:00 p.m. National Park College Gym.
Do not bring dogs orientation night - please note-All classes meet at 7pm orientation night
Looking forward to seeing you! Remember; a dog that knows more is more fun to know! More information 501-525-3297