HIGH FLY’N AGILITY TRAINING CENTER

               ENROLLMENT FORM FOR AGILITY CLASSES

  Please place a check by the class for which you are enrolling:

 
Name: ____________________________________________________  Home Phone:_______________

  Work Phone:________________   E-MAIL:_________________________________________________

  Address:____________________________ City:________________ Zip:__________

  Dog's Name:_______________________________  Age:________     Breed:______________________

NOTE:  Proof of vaccinations must be furnished and kept current (DHLPC, RABIES & BORDATELLA).

  With whom did you complete your training so far? ____________________________________________

What classes did you take? ______________________________________________________________

Are you experiencing any problems in training? _______________________________________________

What goals have you set for you and your dog? ______________________________________________

WAIVER, ASSUMPTION OF RISK AND AGREEMENT TO HOLD HARMLESS

I understand that participation in dog obedience training is not without risk to myself, any family members or guests who might attend, and to my dog. Knowing this, I hereby waive and release Joan Jung , her Agents, Shiloh Road Kennels (High Fly’n Obedience Training Center), from any nature, for injury or damage suffered as a result of my participation in any class or private lesson, including any damage or injury resulting from the action of any person or dog, or for any accident occurring on the premises or its surroundings.  I agree to accept full responsibility for my actions, those of my family or guests and of my dog.

Please sign: _______________________________________________

 
Mail the completed form and a copy of your dog's vaccination record to:

  HIGH FLY’N OBEDIENCE TRAINING CENTER
3880 SHILOH ROAD
MIDLOTHIAN, TX 76065

Shiloh@aircanopy.net   972-723-3880