Iron Range Dog Training Club – 2010 SUMMER TRAINING APPLICATION FORM
MONDAY
Agility Foundations $70
Agility Weaves & Contacts $70
Agility Advanced $70
TUESDAY
Puppy $60
Beginner $70 (aft)
Novice $70
Beginner $70 (evn)
Competition $70
WEDNESDAY
Rally $70
Puppy $70
Tweeners $70
Iron Range Dog Training Club
P.O. Box 14 Virginia, MN 55792
Please circle the desired class above and complete the form below. Class times are listed on the Fall Training Session Class Schedule. Dogs adopted from the Humane Society or Contented Critters receive a $10.00 deduction on training in a puppy or beginner class. Owners must show adoption receipt to registrar on the first night of class. Children under 16 who are enrolled in a 4-H dog project receive free training for their first class upon proof of enrollment. If you did not bring your rabies certificate tonight you must bring it on your first night of class.
PLEASE COMPLETE ALL INFORMATION:
Name: _______________________________________________________Age of Handler if Under 18: ________
Address: ____________________________________________________________________________________
City: ________________________Phone:________________ Email: ____________________________________
Dogís Name: ___________________________________Breed: ________________________________________
Male or Female (Circle One) Spayed or Neutered (Circle one if applicable) Age of Dog: _________________
Name of Vet Clinic: ______________________________________
Date of Rabies Shot: ______________ Tag#: _____________ Expiration Date: _________________
If adopted from shelter, date adopted: 4-H member information:
Circle One: MEMBER or NONMEMBER
Paid by cash____ or check #________ Amount Paid $_________
How did you hear about IRDTC?_____________________________________
Are you interested in learning about membership in IRDTC? _____________
On behalf of myself, my heirs, executors, administrators and assignees; I hereby waive and release any and all rights and claims for damages which I may have against the Iron Range Dog Training Club, its Board of Directors, training directors, and training staff, as well as any others connected with this class or event, their heirs, executers, administrators, successors and assignees for any and all injuries which I and /or any member of my family and /or friends, or my dog may suffer or cause while taking part in this class or event or as a result thereof.
Signature: _____________________________________________________ Date: ___________________
All information was verified by (Registrarís name):