Application For Training CLASSES

Golden Triangle Obedience Training Club, Inc.

Telephone 800/281-0920 Or 412/653-6880

http://www.GTOTC.com or E-mail to gtotcgooddog@hotmail.com

FILL OUT ONE APPLICATION FOR EACH CLASS: (Check off class and date choices where applicable)

8-week Obedience Classes	Day	Fees for Nonmembers	Wednesday Agility Classes (6 weeks)	Fees for Nonmembers	^2/Fees for Members
KPT (12-26 weeks of age)	Mon.	$85	Beginning Agility	$70	$25
KPT (12-26 weeks of age)	Fri.	$85
KPT (12-26 weeks of age)	Sat.	$85	Intermediate Agility	$70	$25
Basic	Mon.	$85/$70^1/
Basic	Fri.	$85/$70^1/	Advanced Agility	$70	$25
Basic	Sat.	$85/$70^1/
Beginning Novice	Thurs.	$70	Jumpers	$70	$25
Advanced Novice (CD)	Thurs.	$70
Open (CDX)	Tues.	$70	Weaves	$70	$25
Utility (UD)	Tues.	$70
Run Throughs on nontraining days as announced - $5 for nonmembers and $3 for members for each 10 minutes.
^1/ Basic = $85 ($70 if attended KPT with the same dog) ^2/ Associate Members must pay full fee for all training classes.

Owner's and/or Handler’s Name:			Home Phone
Address:			Work Phone
			Zip
Email Address:
Dog’s call name:	Birth Date:	Sex:		Breed:
Veterinarian's name and address:

The following information and the presentation of current health certificate/shot record are required at the first class.

Does the dog have any physical handicaps or medical problems? (Explain)________________________________________________

Is the dog spayed or neutered? Yes No Is the dog kept: in the house crated outside pen tied kennel

Has the dog ever been trained in: obedience conformation field agility . If you checked any of these items, please list what level of training and organization where training was obtained _______________________________

How did you hear about Golden Triangle Obedience Training Club? __________________________________________________

Does handler have previous experience? If yes, to what level __________________________________________________________

Age of handler if under 16 ______________ (must be accompanied by an adult at all classes)

Does the handler have any physical handicaps affecting mobility, sight, hearing, etc., that we should be aware of? Yes No

What bad habits does your dog have? Check all that apply:

Barks/Howls

Growls

Runs Away

Jumps Up

Chase Bites

Wets

Other (explain on other side)

How would you describe your dog’s personality? Check all that apply:

	Shy	Friendly	Fearful		Happy			Aggressive		Playful	Nervous
	Bored	Hyperactive	Loud		Annoying			Calm		Jealous	Submissive
	Territorial	Finicky	Indifferent		Dominant			Extroverted		Dependent	Other
I hereby certify that I will indemnify and hold harmless the Golden Triangle Obedience Training Club, Inc. (“Club”) and all persons connected therewith in any capacity whatsoever from any and all liability, cost and expenses for injury or damage to persons or property caused by any dog brought by me to a training class or other event held or sponsored by the club; that I release the club and all persons connected therewith in or in any capacity whatsoever from any and all liability, cost and expenses for any injury or damage to my person or property sustained at the training classes or any event held or sponsored by the club; and that I assume the risk of such injury or damage.
Signature Of Owner/Handler									Date
Applications and tuition fees must be submitted to the training secretary prior to the beginning of a class. Under no circumstances will anyone be permitted into a class by just coming or showing up with an application. Nobody other than the training secretary can approve your admittance to the class. This is strictly enforced to keep classes from becoming overcrowded. Thank you for your cooperation
Enclosed is a check in the amount of $ _________				YES		NO	N/A