Adult Registration Packet

 

 

 

 

 

 

 

 

Adult Registration Packet

 

Best Paw Forward Dog Training - Beginner Class – Wednesday 6:00pm

 

                                                   

Breed: _____________________Dog’s name:_________________________ Dog’s age:_______

Person handling the dog in class:_____________________________________________________________

 

NOTE REGARDING CHILDRENChildren handling the dog must be at least 10 years old unless given special

permission by the instructor.  All children under age 16 must be supervised by a parent.  I welcome participation by the whole

family in training the dog; however, children should never run, squeal or approach a dog.  

 

AGGRESSIVE DOGS NOT ALLOWED   (call if you think you may have a problem)

 

How did you hear about this class?  (_)flyer  (_)web  (_)phone book  (_)friend or vet__________________

 

PLEASE READ AND SIGN RELEASE OF LIABILITY

I (we) hereby release and indemnify Best Paw Forward, LLC., it’s personnel and the owners and operators of any facility at which

Best Paw Forward conducts training classes, from and against claims, demands, losses, costs, expenses, liabilities, damages,

recoveries, and reasonable attorney's fees, which directly or indirectly arise or result from the actions or inactions of me or my

pet(s) at or during a training situation or on training grounds, including injury or death to any person or pet and property

damage.  There will be no refunds.

 

Name: __________________________________________________  Date:  ______________________________

 

Phone (850) 572-0653      Email bestpawforward@cox.net    Website  www.bestpawforward.info

 

Due to the popularity of the classes, sign up on the first night might not be available – pre-registration required.  Email confirmation is sent, please contact me if you do not receive this within a few days of registering.

 

INSTRUCTOR ONLY COMPLETE (please send copies of your shot records with this form)

(_)  Rabies( over 18 wks – required)                                              

(_)  DHLPP combo which usually includes:  Distemper, Parvovirus, Para influenza, & Hepatitis         

(_)  Bordetella/ Kennel Cough  please check your records, not all vets give this vaccination

 

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Best Paw Forward Dog Training Oct 25

Circle one:

Beginner 6 p.m.   Level 2  7 p.m.

Gull Point Resource Center

7000 Spanish Trail, Pensacola

Wednesdays 6:00pm

$120.00 City Residents (city limits—black trashcan)

$130.00 Non-City (county or other—green trashcan)

 

Make check payable to:  City of Pensacola

Mail to:  Best Paw Forward

1310 E. Strong St. Pensacola FL 32501

Please Check One:

__City Resident

__ Non-City Resident

 

Participant Information Form

Please use the following spaces for each of your general information:

 

Participant Information:

 

First name

Last name

Nickname

DOB

 

        /            /

 

Current Age

Email Address

 

 Participant Address & Contact Information:

 

Home Address

City

ZIP

State

Home Phone

Cell Phone

Work Phone

 Image Release

In consideration of myself being allowed to participate in the City of Pensacola Program, related events and activities, the undersigned agrees that such participant’s likeness may be photographed or videotaped and that such images may be published in an outlet used to promote or publicize that program.

Hold Harmless Agreement

I acknowledge that I am releasing the City of Pensacola, its agents and employees, from any and all liability, either individual, joint or several, which they may incur as a result of any act or acts of negligence, contributory negligence, or comparative negligence, engaged in by them which causes, either directly or indirectly, any injury, sickness or illness of any kind, to my child. I further agree that I will hold the City of Pensacola, its agents and employees, harmless from any liability, payment of damages, and attorney’s fees, and will indemnify the City, its agents and employees in the event that the payment of damages, costs and attorney’s fees is incurred by the City, arising out of or pertaining to in any way the negligence, contributory negligence of an employee or agent of the City of Pensacola, or of the City of Pensacola itself.

I agree and understand the Image Release and Hold Harmless Agreement listed above.. I/we also hereby grant consent to all health care providers designated by the City of Pensacola to provide me with any necessary medical care as a result of any injury or illness.

 

 

______________________________________ ______________________________________ ______________

Participant’s Signature                                        Participant’s Name Printed                                   Date

 

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