Wetaskiwin Animal Clinic
4735- 39th Avenue, Wetaskiwin, Alberta, T9A 2J4
Class:___________________ Start Date/Time:________________
Contact # _________________ Contact #2___________________
Male/Female Spayed or Neutered: Yes/No
How long have you owned your dog:__________________
Has your dog ever attempted to or bitten anyone? Yes/No
Proof of Vaccination:_________________________
Any Behaviour problems you wish to be addressed?
How did you hear about our classes?
Would you like to be contacted in the future regarding upcoming classes?
AGREEMENT TO HOLD HARMLESS, WAIVER AND ASSUMPTION OF RISK
I understand that attendance of a dog training class is not without risk to myself, members of my family or guests who may attend, or my dog, because some of the dogs to which I will be exposed may be difficust to control and may be the cause of injury when handled with the greatest amount of care.
I hereby waive and release the Wetaskiwin Animal Clinic Ltd. Hereinafter referred to as the Training organization, it’s employees, officers, members and agents from any and all liability of any nature, for 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 session, or any other function, of the Training Organization, or while on the training grounds or the surrounding area thereto.
In consideration of and as inducement to the acceptance of my application for training membership by this Training Organization, I hereby agree to indemnify and hold harmless this Training Organization, its employee’s, officers, members and agents from any and all claims by any member of any family or any person accompanying me to any training session or function of the Training Organization, or while on the ground or the surrounding area thereto as a result of any action by any dog, including my own.
In case of failure to sign registration form and agreement to hold harmless, waiver and assumption of risk participation in the first class will constitute acceptance of this.
Footwear – must have enclosed back or strap on the back, no flip flop sandals
Signature of Owner, parent, legal guardian or authorized agent for class registration and agreement to hold harmless, waiver, and as