Clermont County Dog Training Club
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CCDTC Pay Pal Agility Class Registration Page
This form is for registering for
Agility
classes only
Please be sure to enter all the information correctly in the boxes.
One form per dog/class, please.
There is a 4% charge for registering via Credit Card.
Please complete ALL the boxes in this form.
*
Indicates required field
Name
*
First
Last
Full Address
*
Phone Number
*
Email
*
Your email will not be shared
Dog's Name, Age and Breed
*
Select your class:
*
Intro to Agility Equipment & Skills
Agility Skill Building
Beginning Agility 3
Back to Basics Agility
Agility Courses and Handling
Intermediate Agility
Focused Fundamentals
Courses
Competitive Agility
Technical Handling
Advanced Agility Handling
Agility Fun Runs
4 Week Class
4 Week Classes- type name of class:
*
4 Week Classes: Type name of class here:
Class Price
*
$105 - non-members price ($109.20)
$25 - members price ($26.00)
$90 - further classes for same dog in same calendar year ($93.60)
$85 - first class for rescue dog within 6 months of adoption,($88.40) (Proof of adoption required with registration form or first day of class.)
$74 - coupon price -must give coupon to instructor at first class
Voucher (send to Registrar)
$50 - non-members 4 week classes only
$15 - members 4 week classes only
Start DATE: mm/dd/yy
*
Start TIME: 00:00
*
Coupon Code, if applicable
*
enter code and give coupon to instructor at first class
If trainee is under 18 yrs of age, enter name of parent or guardian who is authorizing
*
Class confirmations will be e-mailed or called shortly before starting date.
Release
By submitting this Registration form, I hereby release and agree to hold harmless the Clermont County Dog Training Club Inc., its instructors, trustees and officers from any personal injury or damage or injury to any dog owned by me, including any liability, cost or expenses associated with the foregoing, arising-out-of, or during training classes sponsored by CCDTC, inc.
In addition, I understand that it is my responsibility as a trainee to keep my dog(s) under control at all times before, during, and after classes, and to refrain from the use of harsh or abusive training methods at any CCDTC Inc. activity. Failure to comply with the above may result in loss of training privileges and forfeiture of monies paid.
Contact Carol Glenzer (Registrar) if you have questions by phone at (513)502-2700 or by email at
ccdtcagilityregistrar@gmail.com
.
Submit
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