K9 Nose Work Class Registration Form Class you are registering for: Select Class:*6 week Intro to Nose Work Class, $170Second6 Week Intro to Odor Class Choice, $170Third 6 Week Continuing Odor Nose Work Class, $150Clinic/workshop, $40Drop In Class, $35Continuing Odor, Multiple dog 6 week class $10 off each dog, $140Owner InformationName* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone Number (Best # to reach you-cell or home)*Email* Dog InformationDog's call name*Dog's breed*Dog's birthday* Date Format: MM slash DD slash YYYY Dog's sex*FemaleFemale spayedMaleMale neutered General InformationHow did you hear about us?Where did you get your dog?How long has your dog lived with you?Who is your Veterinarian?Does your dog have any behavioral issues (please give details):Does your dog have any physical limitations we should know about for training or homework?NoYesPlease explain:Do YOU have any physical limitations we should know about for training or homework?NoYesPlease ExplainPlease describe a typical week day for your dog?Please describe a typical weekend day for your dog?Where does your dog sleep?Where does your dog stay when you are not home?How often and how long do you walk your dog on leash off the your property?What type of your food does your dog eat? How much and how many times a day?Name 4 things that your dog loves. LIABILITY WAIVER By clicking submit below to register with Let's Talk Dogs, LLC, you agree to the following: General Agreement: In consideration of the acceptance of this registration, and the holding of classes, and the opportunity to have the dog participation, I agree to hold Let’s Talk Dogs, LLC and Dorothy Turley, the premises upon which the classes are to be held and their employees and their assistants, harmless from any claim for the loss or injury which may be alleged to have been caused directly, or indirectly to any person or thing by any act of dog or person while in or upon the premises or ground or near any entrance thereto. I personally assume all responsibility and liability for any such claim. I further agree to hold the aforementioned parties harmless from any claim of loss of this dog by disappearance, theft, death or injury caused or alleged to be cause by the negligence of the parties aforementioned, or by the negligence of any other person or any other cause or causes. I hereby assume the sole responsibility for and agree to indemnify and save the aforementioned parties harmless from any and all loss and expenses, including legal fees, by reason of the liability imposed by law upon any of the aforementioned parties for damage and expenses. Photo Release: I agree to allow Let’s Talk Dogs, LLC to use videos and photos of training sessions for educational purposes unless stated otherwise. Provide your digital signature in order to indicate your agreement to these terms. Your digital signature can be any combination of letters, numbers, spaces and/or punctuation marks placed between two forward slash " / " symbols. Examples of acceptable signatures include /365-2014/, /jd/ and /john doe/.Signature*Date* Date Format: MM slash DD slash YYYY Thank you for registering! You will receive a separate email confirmation with more class details. Once we review your application you will be sent a link for payment.Total $0.00 NameThis field is for validation purposes and should be left unchanged.