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Registration for Sioux Empire
Kennel Club Classes
Summer 2010
I am registering for (Check One):
________Beginners Obedience for Adolescents - Monday 6:30
________Beginners Obedience for Adults - Monday 7:30
________Puppy Kindergarten - Tuesday 6:30
________Conformation - Tuesday 7:30
________Novice Obedience - Wednesday 6:30
________Rally Obedience - Thursday 7:00
Fill in the information below. Please print legibly.
Name__________________________________
Address________________________________
Phone__________________________________
Email address____________________________
Dogs Name___________________Dogs Age__________
Breed__________________________________
Please enclose your check made out to the Sioux Empire Kennel Club.
for $60.00. If a 2nd dog is being registered, and is from the same family,
the cost for the 2nd dog is $30.00. If you take puppy class, you will qualify
for a $5.00 deduction for all classes that you take in subsequent sessions as
long as you have no breaks in enrollment. If you are paying less than full
price due to a deduction you are eligible for, please explain the deduction
on the bottom of this page. Also, if you are registering for a class that
requires passing a Beginners Obedience class, please note when you took the
class at the bottom of this page. Classes are 6 weeks long. There must be a
minimum of 5 dogs registered to hold a class.
Please mail the completed registration form, signed waiver of
liability, copy of vaccination records and your check to:
Mike Bode
% SEKC Training Classes
309 Switch Grass Trl
Brandon, SD 57005
Checks should be made out to the Sioux Empire Kennel Club or SEKC.
For conformation of enrollment email: sekcclasses@yahoo.com
All registrations must be received no later than Monday, May 24th,
2010
Release, Waiver, and Assumption of Risk I,
________________________________________________________________ (the
"Releasor"), hereby release and discharge the Sioux Empire Kennel
Club, its members, and instructors (collectively the "releasee") of
and from any and all liabilities arising from or by reason of any accident,
act, omission, matter, cause, or thing related to my participation in the dog
training classes offered by the Releasee and hereby waive all claims,
demands, actions, or rights of action against the Releasee. The Releasor
hereby assumes full responsibility for the risk of bodyily injury, death, or
property damage due to his/her participation in the dog training classes
offered by the Releasee. Releasor ________________________________________
Mail along with a copy of vaccination records (see class policies for
required immunizations) and payment of $60.00
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