Mailing Address:
5966 FM 2264
Rhome, TX  76078
Phone: 940-627-3612
E-Mail: debbie@pawsagility.com

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Name:________________________________________________________________________

Address:______________________________________________________________________

City:______________________ State:_____________________ Zip: ______________________

E-Mail Address:_________________________________________________________________

Phone: (Daytime)__________________ (Evening)_________________(Cell)_________________

Class Desired: Agility: ____________ Puppy Agility: ___________ Obedience: _______________

Preferred Class Time: Daytime ____     Evening ____      Date to Start: ______________________

Dog's Call Name:_________________________Breed: ________________________________

Sex:_____   Date of Birth:______________ Who referred you? ___________________________

RELEASE AND HOLD HARMLESS AGREEMENT
I understand and assume the possible risks inherent to all dog-related activities, including, but not limited to, bodily injury to myself, my dog, or to anyone accompanying me to the dog agility training classes offered by Debbie Spence d/b/a PAWSitive Agility Working School, at any location such training classes are offered, including, but not limited to, the premises located at 5966 FM 2264 Rhome, Texas.  I further understand that this Release and Hold Harmless Agreement has no time limitation and will remain in full force and effect as long as I train with PAWSitive Agility Working School, regardless of the location of such training classes and regardless of what dog I am training.

Therefore, in consideration of the privilege of training my dog with PAWSitive Agility Working School, I do hereby agree to hold harmless and indemnify Debbie Spence, individually and as principal of PAWSitive Agility Working School, any and all persons who might assist her with her classes, and also the owners of any location where such training classes are offered, of and from any claim for damages and/or injuries I might sustain while participating in such training classes, and further release her from any liability or responsibility for any accident, damage, injury, or illness to me, or to any dog owned by me, or to any family member or spectator accompanying me on the training premises, wherever such training premises may be. I understand that the training premises as used in this Release and Hold Harmless Agreement shall include any location where such training classes are held, including, but not limited to, the premises located at 5966 FM 2264 Rhome, Texas.

Signature of Trainee:___________________________________________Date:___________

Printed Name:_______________________________________________________________

IN THE EVENT THAT THE TRAINEE IS A MINOR, IT WILL BE NECESSARY FOR A PARENT OR GUARDIAN TO SIGN THIS RELEASE AND HOLD HARMLESS AGREEMENT:

I have read the above and foregoing Release and Hold Harmless Agreement provisions and agree to abide by them.

Signature of Parent or Guardian:__________________________________Date:___________

Printed Name:_______________________________________________________________