419-332-DOGS(3647)
Canine Bliss, LLC Class Registration Form
This form needs completed for all classes. Be sure to call first to check for availablity! Reservations will not be held without payment. Thank you!
What class are you registering for?
Time of Class:
Start Date:
Owner/Handler's Name: Phone Number:
Address:
City:
State:
Zip code:
E-Mail:
Dog's Name:
Dog's Breed:
Birthday Month & Year:
Sex:
Spayed/Neuter:
I certify that my dog(s) who will be attending training classes is (are) current on vaccinations and I have received the concurrence of my veterinarian for my dog to attend classes if there are any health (i.e. lameness or medications) which might interfere with my dog's ability to participate.
Your Veterinarians Name, Practice, & Phone Number:
Date last Given:
DHLP/P (Distemper combo):
Rabies:
Bordatella (Kennel Cough):
Canine Bliss, LLC Waiver of Liability
I uderstand that attendance at a private or group dog training class, event, and/or function is not withut risk to myself, to members of my family, to guests who may attend with me, or to my dog(s), since there may be situations and dog(s) to which I will be exposed that may be difficult to control and may be the cause of injury to persons or dogs, even when handled with the greatest degree of care and precaution.
I assume full responsibility for myself, for my dog and for anyone attending with me. I further agree to hold Canine Bliss, LLC, Kris Bliss, it's agents, volunteers and employees and facility/property owners and management faultless for any illness, injury or loss that may occur to myself, to my dog, and to anyone attending with me. I, the owner of the dog described above, hereby agree to secure a proper training collar and leash as dircted by Canine Bliss, LLC, and to wear proper clothing and shoes for safety to permit effective training of my dog. I agree to provide proof of vaccinations as requested and understand that my dog may not be admitted to class without such proof being provided. I pledge to abide by the stated rules and will insure the same of my companions.
I understand that the degree to which a dog is successfully trained is a function of the interest, commitment, and cooperation of the owner. I acknowledge and agree that there is no quarantee that my dog will achieve the desired level of training despite the best efforts of the instructor.
I further understand that once the dog training classes for which I registered have begun, thre is no refund of any kind should I be unable to complete the classes. Enrollment is done on a "first come, first served" basis. Class fees are due in full with a completed Indemnity Agreement, Registration Form, and New Student Profile Form prior to the first class session.
I acknowledge that I have read this Waiver of Liability and that I am entereing into it voluntarily and with full understanding of the terms contained herein. I further agree that this Waiver of Liabilty is binding for this and all subsequent classes, events, and or funcions I attend.
Signature of Owner:
I give my permission for Canine Bliss, LLC, to use any photos taken at a class of me and/or my dog(s) on the Canine Bliss, LLC website or promotional materials.
