OBEDIENCE TRAINING PROGRAM

Basic, Intermediate or Nosework

Enrollment & Release Form


All fields are required. Please use NA if a field is not applicable.

Intermediate Pre-requisite: completion of a basic obedience class or foundation in basic obedience with
the handler. Pease call or email if questions. Phone: 513-877-3325. Email: training@circletail.org.

Name:

Street Address:

City, State & Zip:

Primary Phone: Email:

Date of training program you wish to attend: (mm/dd/yyyy) Event Calendar

Dog's Name:

Breed/Age/Gender of Dog:

Breed:   Age:   Gender: Female Male

Latest Vaccination Dates:

Rabies: DAPP: Bordetella:

Have you trained a dog before? Yes No

How did you hear about these classes?

In which training program are you enrolling?

Basic: $85.00 by check or cash & $87.50 by credit card or PayPal

Intermediate: $75.00 by check or cash & $77.25 by credit card or PayPal

Advanced: $80.00 by check or cash & $82.50 by credit card or PayPal

Nosework: $95.00 by check or cash & $97.75 by credit card or PayPal

How to pay:

When you submit this form you will see a Thank You page that has a PayPal button for the training program. Or you may give us payment when you attend. Please tell us:

Will use the PayPal button Will bring payment to class

Agreement & Release

I understand that attendance at a dog Obedience training class is not without risk to myself, to members of my family or guests who may attend, or to my dog(s), because some of the dogs to which I will be exposed may be difficult to control, and may be the cause of injury, even when handled with the greatest degree and amount of care.

I agree to hold the instructor(s) and Circle Tail harmless for any claims for any loss or injury which may be alleged to have been caused directly or indirectly to any person or thing by the act of my dog while in or upon the training area, or near the entrance thereto, and I personally assume all responsibility and liability for any such claim; I further agree to hold the aforementioned party(ies) harmless for any claim for damage or injury to my dog, whether such loss, theft, disappearance, damage, or injury be caused or be alleged to be caused by the negligence of the aforementioned party, or by the negligence of any other person, or any other cause or causes. I further agree that this Agreement is binding for this and any subsequent classes that I attend.


Please acknowledge that you have read, understand, and agree to the Agreement & Release by typing "YES" (all capital letters) in the following box:

Please provide any additional comment you wish:

Input text from image bellow:


Please click the Submit button only once. It takes a few seconds for the form to be processed.

Having Difficulties?

If you are having difficulties submitting the form, you are welcome to print and fax it to 513-277-6064 (make sure all fields are completed) or print and bring it with you to the training session.

Circle Tail, Inc.
8834 Carey Lane
Pleasant Plain, OH 45162
Phone: 513-877-3325
Email: training@circletail.org