Founded 1960

Associated to New Zealand Kennel Club Incorporated

AGILITY BEGINNER CLASS ENROLLMENT

Name: ___________________________________________________________________

Street: ___________________________________________________________________

Suburb & City: _____________________________________________________________

Telephone: ______________________         Mobile Phone: __________________________

Email: ___________________________________________________________________

NZKC Reg. No. (if one) : _____________________________________________________

Dogs name: ______________________       Breed: ________________________________

Dogs Age: _______________________        Sex: __________________________________

Has you dog/s had any obedience training at a NZKC recognised club?   YES / NO

How did you hear about our club? _________________________________________

I agree that my dog will have vaccinations kept up to date.

I will inform the trainer if my dog has any tendency to bite and will be responsible for all costs incurred as a result of my dog’s aggression.

While all possible care and attention is taken, Akarana Dog Training Club accepts no liability  for any injury or damage caused to handlers, their animals, or any third party.

By signing this form you are agreeing to the above mentioned conditions and agreeing to follow the club and membership rules of Akarana Dog Training Club while participating in club activities.

Signed: _________________________         Date:__________________________________

Paid $ ___________________________       Receipt #: ______________________________