Registration Form
Spring Workshop 2009
WITH DEBORAH JONES, Ph.D. & JUDY KELLER
Topic and Date: TBA
9:00 a.m. - 3:00 p.m.
CANINE ACTION DOG TRAINING CENTER
2715 Easton Street NE
Canton , Ohio 44721
330-493-9707
Please Print
Name: _________________________________________________________________
Address: __________________________________ City _________________________
State: _________Zip: ________Phone: _______________ Email: _________________
Dog name: _______________________ Breed: __________________ Age: _________
Previous training: ________________________________________________________
I want a working team spot ______ CAS staff ______
I want an auditing spot (no dog) _____ CAS staff ______
Lunch is not included.
Enclosed amount $ ________________
(Please make checks payable to "Canine Action Sports" and all registration fees are nonrefundable)
Registration Deadline: TBA
I understand that if my dog shows signs of aggression toward people or other dogs I may be asked to withdraw from this workshop.. To the best of my knowledge, my dog does not bite or attack people or other dogs. I understand that if my dog attacks and /or bites another dog or person, I can be held legally responsible for the medical expenses resulting from such attack or bite. In consideration of the acceptance of this application, and my entering the dog in this workshop, I hereby agree to hold Canine Action Sports and its instructors, assistants, owners, and any and all persons connected with or associated with this organization, harmless from any loss or injury which may occur to any person or anything and/or which may be caused directly or indirectly to any person or thing by any biting by or to, or any other act of said dog or dogs while in or upon the premises or grounds, or in, or at, or near any entrances or exits thereto, whether or not the said dog or dogs is/are being delivered or otherwise handled, and personally to assume full responsibility and liability therefore; for the disappearance and/or loss by theft or otherwise, and/or the death of the said dog or dogs and /or all damages, injury, to the dog or me for any reason whatsoever, including legal fees.
Signature: ______________________________________ Date: __________________