NORTHWEST OBEDIENCE CLUB INC. CLASS APPLICATION
(All Classes Are 8 Week Sessions-Except Session 6)
NOTE!: Check the CLASS SCHEDULES before filling in this application.

INFORMATION ABOUT YOU AND YOUR DOG

Your Name: Contact Phone Number:

Your Address: City:

State: Zip: Best time to contact you:

E-Mail Adress:

Your Dog's Name: Breed: Gender:

Dog's Birthdate: Age of dog when class starts:

Dogs last physial exam: Date dogs stool was checked for worms:
Dates Inoculated for DHLP-P: 1st: 2nd: 3rd:
(Note: for dogs under 1 year of age, there are three inoculation dates for DHLP-P)
Inoculated for Rabies on: Tag/Certificate # 1 year 3 year

What is the name of your veterinarian/animal hospital?
Vet's Phone Number:
Address:
City: State: Zip:

Important!!! Please read and sign below and print both pages:

Your Name: Page 2

TRAINING HALL RULES, POLICIES AND AGREEMENT

Application for training must be signed by the person who will handle the dog during classes or parent/guardian in the case of a minor. Minors must be at least fourteen (14) years old by the first day of class. Exceptions are approved by the Director of Training.

• Full Training Fee is required in order to reserve a place in class.
• No Training Fee will be refunded after the first night of class.
• NOCI recommends a slip collar for Beginners classes. Only buckle collars are permitted in puppy classes.
• Family members and friends are welcome to watch quietly.
• It is your responsibility to keep your dog under control at all times. All dogs must be restrained from barking, whining, growling, or snapping at other dogs or people for any reason.
• If you need help or instruction in correcting these actions, please ask your instructor or Director of Training. Dogs which bite, attack, or appear to be threatening to other handlers or their will not be allowed to remain in the training hall, unless they are muzzled and have the approval of the Director of Training.

STATEMENT OF HEALTH

I hereby swear, attest, and affirm that this animal is currently inoculated against Rabies, DHLP-P and all other diseases as required by local ordinance, and it is free from fleas, worms, communicable parasites and diseases. If at any time I become aware that this animal has contracted any of the above, (or any condition that may pose a health risk), I will immediately inform my class instructor and/or an officer of NOCI.
I further recognize that I have an obligation to all persons who participate in any class and will refrain from bringing animal onto NOCI property that does not have all required innoculations up to date, or has any parasitic condition, until that condition is no longer a threat. By my signature on this form. and by selecting "I Agree", I hereby authorize my veterinarian to release information on this dog regarding inoculations, diseases, and communicable parasites to an authorized NOCI representative upon request.

TRAINING AGREEMENT

I hereby apply for training priveleges at Northwest Obedience Club, Inc. I agree to conduct myself in accordance with the rules governing training at this facility. I further agree to assume full responsibility for the conduct of my dog while on club property, and release Northwest Obedience Club Inc. from any and all claims, actions, or causes of action arising out of or in connection with training classes or the actions of my dog. I understand that my enrollment fee will NOT be refunded after the first night of class, and there will be NO make-up session or partial refunds should classes be cancelled due to circumstances beyond NOCI control (power outages, weather etc.). I hereby affirm that I have read and understand and hereby agree to adhere to all conditions and statements contained in this application.