Seminar, Workshop, and Run-Thru Registration Form

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*

. Your website Your blog Email newsletter Craigslist Word of mouth Flyer in store Vet On another website Other

Other:

Name*

Breed*

Sex

Male      Female

Is your dog spayed or neutered?

Yes      No

Age*

If applicable, please briefly describe what you hope to get out of this workshop:

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.*