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MEMBERSHIP Application |
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Membership Application Please cut and paste to word document, fill out the form, sign the waiver, and send by snail mail to:Martha McGrath26 Wellington Drive Bluffton, SC 29910
Proof of most recent vaccination must be provided with application. Bordetella requested.
Fee for Initial Membership: $35.00 ($15.00 for each additional dog, Note: Annual dues may be a separate fee.) Please sign waiver at bottom of page.
Name: ________________________________________________
Address: Street ________________________________________
City, St, Zip ________________________________________________
Telephone Home ________________________________________________
Mobile ________________________________________________
Email ________________________________________________
Dog Information: Please list each dog to be involved in Rally practice separately.
1. Dog’s Name ________________________________________________
Breed/Mix ________________________________________________
Age ____________________ Sex __________________
Spayed/Neutered Yes ___ No ___
AKC Registered Yes ___ No ___ APDT Registered Yes ___ No ___
Titles Earned ________________________________________________ Obedience training __________________________________________ |
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2 Dog’s Name ________________________________________________
Breed/Mix ________________________________________________ Age ____________________ Sex __________________
Spayed/Neutered Yes ___ No ___
AKC Registered Yes ___ No ___ APDT Registered Yes ___ No ___
Titles Earned ________________________________________________
Obedience training __________________________________________
WAIVER, ASSUMPTION OF RISK AND AGREEMENT TO HOLD HARMLESS I understand that attendance at a dog obedience session is not without risk to myself, members of my family or guests who may attend, or my dog, because some of the dogs to which I will be exposed may be difficult to control and may be the cause of injury even when handled with the greatest amount of care. I hereby waive and release the Club, its employees, officers, members and agents from any and all liability of any nature, for injury or damage which I or my dog may suffer, including specifically, but without limitation, any injury or damage resulting from the action of any dog, and I expressly assume the risk of such damage or injury while attending any practice, training session or other function of the Club, or while on the training grounds or the surrounding area thereto. In consideration of and as inducement to the acceptance of my application for membership by this Club, I hereby agree to indemnify and hold harmless this Club, its employees, officers, members and agents from any and all claims, or claims by any member of my family or any other person accompanying me to any practice, training session, or function of the Club, or while on the grounds or the surrounding area thereto as a result of any action by any dog, including my own.
___________________________________ _______________ (Signature) (Date) |
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Rally Club of the Low Country E-mail: lee@dogrally.org |