SMKC Class Registration Form

Please fill out this registration form.  

Are you an Existing Student? Yes No

Three items are REQUIRED to attend class and must be brought the FIRST night:

  1. A copy of your dog's vaccination record showing dates of at least 2 DHLPP shots
  2. A check for $80.00 (unless specified) payable to S.M.K.C.
  3. A signed waiver (see bottom of form)

Fees for non-members (unless otherwise specified): $80 per session

Fees for current members (unless otherwise specified): $40 per session

Name of Owner/Handler:   

Mailing Address: 

City:    State:    Zip Code: 

Home Phone:    Work Phone: 

Cell Phone:   Other Phone:

Email Address: 

FIRST DOG

Dog's Information

Dog's Call Name:    Dog's Date of Birth: 

Breed of Dog:    Was s/he from the humane society?

Previous Training Experience:

Puppy Kindergarten

Puppy Beginner Obedience

Beginner Obedience

Canine Good Citizen (CGC)

Pre-Novice Obedience

Novice Obedience

Pre-Open Obedience

Open Obedience

Utility Obedience

Foundation Agility

Beginner Agility

Intermediate Agility

Competition I Agility

Competition II Agility

Rally Obedience Novice

Rally Obedience Advanced

Handling

Other 

1st Class Registration

Class you'd like to join:

Day of the week the class is held:

Time of Class:

2nd Class Registration

Class you'd like to join:

Day of the week the class is held:

Time of Class:

SECOND DOG

Dog's Information

Dog's Call Name:    Dog's Date of Birth: 

Breed of Dog:    Was s/he from the humane society?

Previous Training Experience:

Puppy Kindergarten

Puppy Beginner Obedience

Beginner Obedience

Canine Good Citizen (CGC)

Pre-Novice Obedience

Novice Obedience

Pre-Open Obedience

Open Obedience

Utility Obedience

Foundation Agility

Beginner Agility

Intermediate Agility

Competition I Agility

Competition II Agility

Rally Obedience Novice

Rally Obedience Advanced

Handling

Other 

1st Class Registration

Class you'd like to join:

Day of the week the class is held:

Time of Class:

2nd Class Registration

Class you'd like to join:

Day of the week the class is held:

Time of Class:

Do you have more than two dogs that will be attending classes?  If so, please enter your needs in the field below.

If other classes are desired, please enter Dog name and class here:

Additional comments:

Are you a member of the Salisbury Maryland Kennel Club? Yes No

   Thank you for your interest in classes at the Salisbury Maryland Kennel Club!

Waiver:

I , do hereby release the Salisbury Maryland Kennel Club and/or the training class instructors from any liability, obligation, or responsibility resulting from participation in the class/classes and knowingly assume all risk involved to myself, my animal/s, my personal property, or otherwise. 

I understand that entering my First & Last name into this box will constitute as my signature on this form. 

                              How did you hear about us?

                                      Television (What channel?)

                                      Daily Times

                                      Sussex Guide

                                      Webpage

                                      Friend or Referral (Please specify whom)

                                      Other (Please specify)

AFTER YOU SUBMIT THE REGISTRATION, PLEASE PRINT A COPY AS CONFIRMATION OF YOUR ENROLLMENT IN THE CLASS SELECTED. 

The Registrar will contact ONLY if there is a change.