Full  Name

Address

City

Zip

State

arrow&v

Email

Phone

USA Membership Number

Trial Helper Book Number

Current Classification

arrow&v

(select one)

arrow&v

(select one)

Desired Classification

2019 New England Regional Helper Seminar Registration

** All fields are required - Please enter text exactly how you want it to appear in the official paperwork **

INFORMED CONSENT AND RELEASE

I wish to participate in the United Schutzhund Clubs of America Helper Program/Seminar (hereinafter referred to as the “program”) and to use the equipment, facilities and services (hereinafter collectively referred to as the “facilities”) made available by the program. I agree that my participation in the program and the use of the facilities are and will at all times be at my own risk. I will be responsible for my actions, the actions of any minor(s) under my supervision and for any animal(s) that I choose to handle in the program.

I hereby agree to accept all risks associated with the use of the facilities made available to me as a participant in the program and that the United Schutzhund Clubs of America, the Helper Committee, Official Teaching Helpers, Inner City WDC have made no guarantees or representations as to the quality and suitability of the facilities for any purpose. I acknowledge that I will seek medical advice from a doctor regarding my participation in the program or use of any facilities. I agree to report any signs or symptoms of distress or abnormalities to the United Schutzhund Clubs of America, the Helper Committee, Official Teaching Helpers, Inner City WDC and hereby consent to the administration of any resuscitation measures deemed advisable by such person.

In consideration for my participation in the program and use of the facilities, I, for myself, my heirs, executors, administrators, successors and assigns, do hereby release and forever discharge the United Schutzhund Clubs of America, the Helper Committee, Official Teaching Helpers, Inner City WDC, their employees, agents, successors and assigns, from all manner of actions, causes of actions, claims, demands or damages whatsoever which may have arisen or may in the future arise for or by reason of any damage, loss or injury to property or person (including death) which I have sustained or which I may in the future sustain, as a consequence of my participation in the program or use of the facilities.

I have read and accept the foregoing

© 2019 by INNER CITY WORKING DOG CLUB. Proudly created with Wix.com

  • Wix Facebook page