WCERA ENTRY FORM TO MAIL OR EMAIL TO ANNELROSENBERG@HOTMAIL.
Welcome to ev-ry earthdog Dog Park!
Entry Form
Dog’s name
SATURDAY SUNDAY. (CIRCLE WHICH DAYS)
Nursery Trial 1 ($5) OR Nursery Trial 2 ($5)
Level 1 Trial 1. ($15). OR Level 1 Trial 2 ($15)
Clinic ONLY ($20)
CIRCLE THE ELEMENT TO BE ENTERED
INDICATE NURSERY OR LEVEL 1 AND ONE OR BOTH TRIALS
Lock and key
Break out
Pirate ship
Puzzled
AMOUNT PAID __________
Call Name:________________________________
WCERA Registration Number:____________________
Dogs Registered Name:_________________________________________
DOB:____/______/_________
Breed:____________________
Owners Name:_________________________
Address:___________________________________________________________
Email:__________________________@_________________
Phone Number: (_______) _____-__________
Emergency Contact: ___________________________ (_____) _____-________
Please sign and include agreement with entry
I (we) acknowledge that if this application for the entry of this dog is made available to me (us) for participation in a WCERA © , that I (we) agree that this facility has the right to refuse the entry of this dog and/or they reserve the right to dismiss the dog and myself for cause which WCERA deems to be
sufficient. In consideration of the acceptance of this and the opportunity to train/trial my dog(s), I (we) agree to hold WCERA, ev-ry earthdog LLC, Anne Rosenberg, Kelly Lengle, and all associates harmless from any claim for loss or injury which may be alleged to have been caused directly or indirectly to any person or thing by the act of this dog or dogs or their handler while in or upon the premises or grounds or near any entrance thereto, and I (we) personally assume all responsibility and liability for such claim, and I (we) further agree to hold the aforementioned parties harmless from any claim for damage or injury to the dog or myself, either physically or mentally, whether such loss, disappearance, theft, damage or injury, be caused or alleged to be caused by negligence while in or upon the premises of the WCERA grounds. The terms of this agreement bind the parties for the current period of training/trialing, and all subsequent classes/training/trialing events in which they hereafter participate. There will be no refunds for acts of God. No refunds at all after closing date unless you have a vet excuse.
Signature of owner or agent duly authorized to make this entry
__________________________________________________________
ENTRIES WILL BE CONFIRMED BY EMAIL. WRITE YOUR EMAIL CLEARLY
ALL ENTRIES MUST HAVE THIS FORM FILLED IN AND SIGNED IN ORDER FOR THE ENTRY TO BE ACCEPTED.
