Jump City Agility

Beginning Class Registration Form
 
To register for a 5 week beginning class, please complete the following form and submit to Jump City Agility.  Please answer all questions and be sure to read the waiver form at the bottom of the form before you click the "Submit Form" box.   
Class date?
Class time?
Name:
Address:
City, State, Zip:
Pnone number:
Email Address:
Dog's Name:
Kind of dog/Breed
Check male or female: Male
Female
Is your dog spayed/neutered? Spayed
Neutered
No
Dog's age:
How long have you had this dog?
Briefly describe any kind of prior training:
Briefly describe any issues or problems such as aggression, fear, anxiety, etc. Add anything else you would like us to know about your dog (especially the good stuff.) 

Where did you hear about Jump City Agility?

 

By reading the following waiver form I understand and agree with this Yes, I agree
No, I do not agree
Today's date:
I have read and understand and agree with the waiver form as set forth below.

JUMP CITY AGILITYŽ (A CALIFORNIA CORPORATION) 
DOG AGILITY TRAINING AGREEMENT AND RELEASE FROM LIABILITY (RELEASE)
ADVANCE PAYMENT – NONTRANSFERABLE
________________________________________________________________________________________________________________________

 Voluntary Participation
1. I acknowledge that I have voluntarily applied to Jump City AgilityŽ for dog agility training. If my application is accepted, I agree that Jump City AgilityŽ may drop me from the training at any time, either with or without cause.

 Assumption of Risk
2. I am aware that dog agility training may be a hazardous activity. I am voluntarily participating in this activity with full knowledge of the potential danger involved. I hereby agree to accept any and all risks of injury to myself, my dog(s), or any dog(s) under my care, custody, or control.

Release
3. As consideration for being permitted by Jump City AgilityŽ to participate in this activity, I hereby agree that I, my assignees, heirs, distributees, guardians, and legal representatives will not make a claim against, sue, or attach the property of Jump City AgilityŽ, its officers, directors, employees, lessors, agents, independent contractors or the City of Los Angeles, for injury or damage resulting from the negligence, howsoever caused, by Jump City AgilityŽ, its officers, directors, employees, lessors, agents, independent contractors or the City of Los Angeles, as a result of my participation in dog agility training. I hereby forever release Jump City AgilityŽ, it officers, directors, employees, lessors, agents, independent contractors and the City of Los Angeles, from all actions, claims, or demands that I, my assignees, heirs, distributees, guardians, and legal representatives now have or may hereafter have for injury or damage to myself, my dog(s), or any dog(s) under my care, custody, or control resulting from my participation in dog agility training.

 Media
4. All rights to televise, video tape, audio tape, advertise, photograph, or otherwise promote the dog agility training are vested in Jump City AgilityŽ or in entities to whom assignments of such rights have been made in writing. By participating in the dog agility training I forever grant to Jump City AgilityŽ the right to televise, video tape, audio tape, advertise, photograph, or otherwise promote the dog agility training and use my likeness, my dog(s), or any dog(s) under my care, custody, or control in any manner whatsoever without further release, consent, or compensation. 

Attorney's Fees/Choice of Law/Forum Selection
5. The prevailing party shall be entitled to costs and attorney's fees in any action or proceeding arising out of this Agreement and Release and/or in any action or proceeding to enforce a judgment based on a cause of action arising out of this Agreement and Release. This Agreement and Release will be governed by, and construed in accordance with, California law. All causes of action arising directly or indirectly from this Agreement and Release shall be filed and prosecuted in the Los Angeles Judicial District.

 Full and Complete Agreement
6. This Agreement and Release supersedes all agreements previously made between the parties relating to its subject matter. There are no other understandings or agreements between them. 

Knowing and Voluntary Execution

7. BY CHECKING THE BOX ABOVE, I ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS RELEASE AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN MYSELF AND JUMP CITY AGILITYŽ.

 

Form created on www.freedback.com