Cape Cod Kennel Club
Puppy Kindergarten Registration

Class Signing Up For:________________________________________Start Date: __________________________
**Please note:  Group Obedience classes are for quiet, friendly dogs.  Dogs that bark excessively or are not friendly toward people or other dogs require private lessons.  If your dog is extremely shy, private lessons that take place in your home are also the best place to start.

Your Name _____________________________________________________________________________________

Address ________________________________________________________________________________________

City, State Zip __________________________________________________________________________________

Telephone _______________________________________________Cell#___________________________________

Email __________________________________________________________________________________________

Dog's Name ___________________________________________________________ Sex (M/F) _______________

Veterinarian:____________________________________________________Spayed/Neutered:___________________

Breed ___________________________________________________ Date of Birth __________________________

My goals: A Well-Behaved Family Pet ______ Competition ______Other _____________________________________________

Prior Obedience Training Classes/Titles:_________________________________________________________________________

AKC S.T.A.R. Puppy - (AKC number needed if registered with the AKC):_______________________________________________
**Please note:  Owner should be owner of dog registered with the AKC.

Release of Liablity:  I hereby waive and release Cape Cod Kennel Club, their 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 training session or any other function or while on the training grounds or the sourrounding area thereto.  In consideration of and as inducement to the acceptance of my registration for training with the Cape Cod Kennel Club, I hereby agree to indemnify and hold harmless the Cape Cod Kennel Club and the 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 training sessions or function of the Cape Cod Kennel Club or whlle on the grounds or the surrounding area thereto as a result of any action by any dog, including my own.  I acknowlege that the enclosed fee is non-refundable.

__________________________________________________________(____________________________)
Signature of Owner (Date)


SEND this completed form AND
- A copy of your puppy's vaccination record, if not already submitted
- A copy of the adoption papers if claiming the one-time $5 rescue discount
- A check made payable to Cape Cod Kennel Club for "Puppy K) $95 ($85 for club members), less the one-time $5 rescue discount if applicable

Contact: Heather Garre, 508-896-0126 or Cell, 508-736-3202 or John Cappellina, 508-362-6506
P.O. Box 2003, Brewster, MA  02631.  (Checks or cash only.  There will be a $25 charge for returned checks)

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