Gemini Dogs, Inc.

Agility Video Workshop Registration Form

Use this form to register for a Gemini Dogs seminar or workshop. There are no refunds without 48-hour notice. * Required fields

Class info
Note: You and your dog must have agility training to participate. Call or email if you are unsure.

Full Name (Handler)*	Must be over 12 years old
Full name (Co-Handler)	Child, spouse, partner, etc.
Street address1
Street address
City
	State Zip Code

Home phone*
Work phone
Cell phone
Email address*
How did you hear about this class?	Other:

Name*
Breed*
Sex	Male Female
Is your dog spayed or neutered?	Yes No
Age*
List all obedience and agility classes you have taken (either here at Gemini Dogs or elsewhere) *
Is your dog friendly toward other people and dogs?*
If applicable, please briefly describe what you hope to get out of this workshop:

Agility Video Workshops
Saturday, April 19: Novice
	Session 1: Novice Standard (9 AM - Noon, $65)
	Session 2: Novice Jumpers & Games (1-3 PM, $65)
	Both sessions: ($120 - save $10!)

Sunday, April 20: Advanced Competition
	Session 1: Advanced Standard (9 AM - Noon, $65)
	Session 2: Advanced Jumpers & Games (1-3 PM, $65)
	Both sessions: ($120 - save $10!)

I have read and agree to the terms of the Waiver, Assumption of Risk, and Agreement to Indemnify and Hold Harmless.

Type your name in the box to indicate your acceptance of the waiver.*

Copyright © 2007 Gemini Dogs, Inc.
53-B Ayer Road Littleton, MA 01460
978-486-9922