ADOG/DTA - Obedience Class E-registration

Student First Name:

(R)

Student Last Name:

(R) Age: (if under 18)

Street:

(R)

City:

(R) State: (R) Zip: (R)

Telephone Home:

(R) XXX-XXX-XXXX

Telephone Work/Cell:

(R) XXX-XXX-XXXX

E-mail:

(R) Check if new/changed.

Confirm E-mail:

(R) Re-enter your e-mail address.

E-mail Changed:

Check if the above is a new address.

Best Way to Reach You:

(R)

DOG #1: Call Name:

(R)

Breed:

(R)

Class Requested:

(R)

Confirm class availability on Schedule page. If marked "FULL", select "Add to Waiting List" as your payment method and you will be contacted. Classes are held in the evening unless noted daytime (AM).

DOG #2: Call Name:

Breed:

Class Requested:

DOG #3: Call Name:

Breed:

Class Requested:

Vaccinations:

(R) I hereby certify that all dogs being registered are current on all vaccinations.

Session Beginning Week:

(R) NOTE: The date shown is the session starting date, see the Schedule page for specific class starting dates and times.

Payment Method:

(R)

Release From Liability:

RELEASE FROM LIABILITY - I hereby waive and release Atlanta’s Dogwood Obedience Group, LLC (“ADOG”) and Ambassador Corp, its employees, officers, members and agents from any and all 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 class, or any other function while on the training grounds or the surrounding area. In consideration of and as inducement to the acceptance of my application for training membership by ADOG, I hereby agree to indemnify and hold harmless the above from any and all claims, or claims by any member of my family or any other person accompanying me to any of the training activities or other sponsored functions, or while on the facility or neighboring area thereto as a result of any action by any dog, including my own.

(R) I agree with and accept the conditions of the above disclaimer. By selecting "Agree", I confirm that it has the same effect of my personal signature agreeing to the conditions of the above disclaimer.

NOTE: After your registration is successfully transmitted, the Registration Confirmation page will open and you process your payment based on the method selected above.