CLASS REGISTRATION

1.     Your name _____________________________________________________

        Address  ______________________________________________________

        City, state, zip _________________________________________________

         Phone (Home) _________________ e-mail ___________________________

           (Work phone) ______________

2.      Dog name    ____________________________________________________

            Breed  _____________________________________ Age ______________

            Sex (circle applicable)           M       (neutered)      F        (spayed)

3.      Which class are you applying for?    Start Date ________

            Obedience
            Puppy Kindergarten _____   3 Steps to CGC _____ 

           Advanced Obedience (level?) ____________

           Rally Obedience ____________    Other _____________

           Agility
           Puppy _______ Intro ________ Obstacle Confidence _______  

                  Pre-Competition _______   Advanced (Competition) Agility __________

           Other Class (please state name of class ________________________________
                             and scheduled start date)

4.      What are your goals for you and your dog in this class?

_____________________________________________________________________

_____________________________________________________________________

5.      List any problems you are having with your dog.

_____________________________________________________________________

6.      Where did you hear about Mountain View? _______________________________

PLEASE READ AND SIGN RELEASE BELOW.  Thank you!

Please return completed questionnaire to the above address as soon as possible.  We also
require a current vaccination record prior to enrollment in our classes. Your payment in
advance is appreciated.  Thank you!

MOUNTAIN VIEW DOG TRAINING
PO Box 36, Amissville VA 20106
(540) 937-2114 or 937-5805
email: info@mountainviewdogs.com
Obedience  -  Agility  -  Private Behavior Counseling
Check out our website at www.mountainviewdogs.com

Release and Indemnification In partial consideration of and as a condition to my exercise of the right to train my dog(s) for obedience or agility upon the property belonging to Kenneth & Averill Ring, located at 766 Viewtown Road, Amissville, Rappahannock County, Virginia, under the auspices of U-NAMIT Inc. DBA Mountain View Dog Training & Agility, I hereby waive, release and discharge any and all claims for damages for personal injury or property damage which I may have, or which may subsequently accrue to me against Mountain View Dog Training & Agility and/or Kenneth or Averill Ring and/or Cathy Hughes or any other person associated with Mountain View Dog Training & Agility, as a result of my activities upon the said property.  This release is intended to discharge Mountain View Dog Training & Agility and its agents from and against any and all liability arising out of or in any way connected with such activities, even though that liability may arise out of negligence or carelessness on the part of Mountain View Dog Training & Agility or any person or entity acting on their behalf. Date                     Print Name                                         Signature _________        ___________________                ______________________________

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