Dog Sports at Kim's

Obedience Class Registration Form

Kim's classes fill early, so don't wait.

Please write in applicable class.  See Master Schedule for class dates and times.

Classes are $80.00 for the set of six weeks.  Walk-ins are welcome; call for pricing (618-293-1750).

Classes for Monday

_____  Monday              _________________________________________________

Classes for Thursday

_____  Thursday             _________________________________________________

_____  Thursday             _________________________________________________

_____  Thursday             _________________________________________________

Classes for Friday

____  Friday              ____________________________________________________

_____  Friday             ___________________________________________________

NAME: __________________________________________________________________________________

ADDRESS: ______________________________________ CITY: ___________________________________

STATE/ZIP: _________________________________ HOME PHONE: _______________________________

WORK PHONE: ____________________________ E-MAIL: _______________________________________

BREED OF DOG: ____________________________ DOG'S CALL NAME: ___________________________         

DOG’S AGE: __________ SEX: _______    SPAYED / NEUTERED          YES / NO

VACCINATION DATES:  Rabies ________________     DHPP __________________

Agreement to Hold-Harmless Waiver & Assumption of Risk

I understand that attendance at a Dog Obedience Training Class is not without risk to myself, members of my family, or guests who may attend, or my dog, as 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 of care. 

I hereby waive and release Dog Sports at Kim’s, Kim’s Canine Club, LLC, Kimberly Berkley, and their agents from any and all liability of any nature for injury or damage 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 training session or while on the training grounds or the surrounding area thereto. 

In consideration of and as inducement to the acceptance of my application for Dog Obedience Training with Dog Sports at Kim's, Kim's Canine Club, LLC, I hereby agree to indemnify and hold harmless Dog Sports at Kim's, Kim’s Canine Club, LLC, and its agents from any and all claims, or claims by any member of any family or any other person accompanying me to any training session, or while on the grounds or the surrounding area thereto, as a result of any action by any dog, including my own. 

If because of riots, civil disturbances, or other acts beyond the control of Dog Sports at Kim's, Kim’s Canine Club, LLC, it is impossible to complete classes, no refund of training fees will be made.

I hereby grant permission to Dog Sports at Kim's, Kim’s Canine Club, LLC, to use any photographs, videotapes, motion pictures, recordings, or other record of events at Dog Sports at Kim's, Kim’s Canine Club, LLC, for any legitimate purpose.

There will be a $15 charge on all returned checks. No equipment is to be used except that approved by the instructor.

Signature: _______________________________________________________Date: _______________

Class fee is due before a class reservation can be made and is NON-REFUNDABLE. 

Please make check payable to Dog Sports at Kim's and mail to:

Dog Sports at Kim's, 1951 Townsley Lane, Caseyville, IL  62232