Sirius Dog Agility: eRegistration

Current Students Only - eRegistration

Return to Students

After your registration is successfully transmitted, the Registration Confirmation page will open and you will select your payment method. E-mail Class Info if you have any questions.

Please review your information carefully before pressing "Submit Registration". (R) = Required Information

HANDLER INFORMATION

Student First Name:

(R)

Student Last Name:

(R) Age: (if under 18)

Best Way to Reach You:

(R)

CONTACT INFORMATION (Enter only if new or changed.)

Telephone Home:

XXX-XXX-XXXX

Telephone Work/Cell:

XXX-XXX-XXXX

E-mail:

SESSION -- PAYMENT METHOD -- LIABILITY RELEASE

Session Starting Week:

Payment Method:

(R) (Fee $140 one dog, $130 each for two or more dogs)

Release From Liability:

Agility can be a physically strenuous and demanding sport. Because of that, there are risks involved in participation. Please sign the release below acknowledging that you understand these risks. Anyone using the Sirius facility is required to sign this release.

I understand that dog training is not without risk to myself, members of my family, and/or my dog. I agree that, in the event of injury to my family, my dog(s), or myself, I will not hold Sirius Dog Agility, it owners or any of its instructors, responsible. I also agree to assume all responsibility for any damage done to property, persons, or other dogs by me or my dog's actions. I hereby release Sirius Dog Agility Training Center, animal owners, animals, property owners, instructors, spectators and or any other participants, from any and all liability for accidents, injuries and/or damages to me, my dog, or any property, caused by participation in any activities including the period of time immediately prior there to, and immediately after, the conclusion thereof, so long as the animals are located on the premises designated for the activity. I assume all liability for injury to myself, my dog or any property, occasioned by this participation. This waiver shall be effective from the date of signing.

(R)	I agree with and accept the conditions of the above disclaimer. By selecting "Agree", I confirm that it has the same effect of my personal signature agreeing to the conditions of the above disclaimer.

CLASS

Same:

Check if all class(es) and/or dog(s) are same as currently enrolled and proceed to "Submit Registration" below.

Changed:

Check if class(es) and/or dog(s) have changed and enter information below.

DOG INFORMATION #1 - NEW OR CHANGED DOG/CLASS

Dog's Call Name:

Breed:

Class:

Vaccinations:

I hereby certify that my dog is current on all vaccinations.

DOG INFORMATION #2 - NEW OR CHANGED DOG/CLASS

Dog's Call Name:

Breed:

Class:

Vaccinations:

I hereby certify that my dog is current on all vaccinations.

DOG INFORMATION #3 - NEW OR CHANGED DOG/CLASS

Dog's Call Name:

Breed:

Class:

Vaccinations:

I hereby certify that my dog is current on all vaccinations.

NOTE: After your registration is successfully transmitted, the Registration Confirmation page will open and you will process your payment based on the method you chose above.

Page Updated 08/12/2008