Agility class Move-Up or Repeat form for the NEXT SESSION.

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This form is used to place you in future sessions and includes a class waiver that must be submitted by all who participate in classes at the GFDTC.

It is NOT a confirmed registration for enrollment in a class, as there may be changes as we determine final numbers. Agility classes after Intro do require the approval of your previous level's instructor to allow move ups. Your instructor will have the final say on eligibility, but will discuss this with you in classes.

The registration coordinator will follow up with you regarding placement and payment after confirming placement with your current instructor.

Last Name of person who will be taking class with dog *

First Name of person who will be taking class with dog *

E-mail Address REQUIRED (confirmation & class communication will be sent by E-MAIL) *

Telephone Number *

Street Address (ex: 123 4th St NW) *

City (ex: Grand Forks) *

State (ex: ND) *

Zip Code (Ex: 58203) *

Is the handler over 18 years old? Write "YES" in box below, or if under 18 please specify AGE of the person who will be handling dog during class. If the child is under 18 the Parent/Guardian must complete the Liability Waiver and registration submission. *

Name of Dog *

Breed of Dog *

Date of Birth of Dog (month/day/year) *

Sex of Dog *

Are Vaccinations Up to Date? *

Yes

If vaccinations are not current please state your reasons in the box below (Titers, vet instructions, etc). If they are current please proceed to the next question.

Is the dog Spayed or Neutered (females in heat are not allowed on the premises) *

Yes

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