OBEDIENCE TRAINING PROGRAM

Classes or Private Lesson

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: admin@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 lessons?

In which training program are you enrolling?

Basic: $90.00 by check or cash & $92.50 by credit card or PayPal

Intermediate: $80.00 by check or cash & $82.25 by credit card or PayPal

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

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

Private Lesson: $75 by check or cash & $76.50 by credit card or PayPal for first evaluation and training session (typically runs 1½ hours).

State the issues you are seeking to address:

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 lesson is not without risk to myself, to members of my family or to 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 of care. In consideration for entry to the premises of Circle Tail, Inc., 8834 & 8778 Carey Lane (Premises), and participation in lessons/activities therein (Activities), I for myself, my listed minor children, and the heirs, assigns, and personal representatives thereof, do hereby agree as follows:

a) I release Circle Tail, Inc., Marlys Staley, and all Officers, employees and agents of Circle Tail, Inc., (“Releasee”) from liability for, waive any right to bring suit against Releasee relating to, and covenant not to sue Releasee for, any and all claims, including claims arising from negligence, resulting in personal injury, accidents, illnesses (including death) and property loss (including damage or injury to my dog), arising from entry to the Premises or participation in the Activities.

b) I acknowledge that entry into the Premises and/or participation in the Activities carries with it certain inherent risks to people, animals and property. Such risks include, but are not limited to, animals that can bite, trip, knock down and fight, indoor and outdoor surfaces that may be slippery, equipment that can trip, persons who cannot control dogs and activities involving dogs that can result in injury from bites and other causes.

I have read the preceding paragraph and know, understand and appreciate these and other risks inherent in entering the Premises and participating in the Activities. I hereby assert that participation by me and/or my minor child/ward is voluntary and I knowingly assume all such risks.

c) I agree, on behalf of the same above-referenced parties, to indemnify and hold Releasee harmless from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney’s fees, arising as a result of my or my child/ward’s entry to the Premises or participation in Activities at Circle Tail, Inc. or as a result of any act of my dog while at the Premises.

I further agree that this Agreement is binding for this and any subsequent lessons 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 513-449-2992 (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: admin@circletail.org