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Application for MEMBER INFORMATION
(Please Print) Name of Member_______________________________________________________ Address ______________________________________________________________ Home Phone ______________________________ Cell Phone __________________ E-Mail Address ________________________ Work Phone _____________________ Person to be notified in event of Emergency _________________________________ Emergency Contact Telephone Number_____________________________________ DOG INFORMATION Dog(s) name__________________________________________________________ Breed(s)______________________________________________________________ Date of last vaccinations (proof required) ___________________________________ Veterinarian (Name and Phone #) _________________________________________ Dog(s) aggressive to people? ____ Has it bitten a person? ______________________ Specify ______________________________________________________________ Dog(s) aggressive to other dogs? ____ Specify_______________________________ Member must submit vaccination certificate. MEMBERSHIP FEES – please circle one Monthly membership $35.00 per month Annual (one year) membership $32.00 per month ($384.00 annual) Annual (one year) membership $348.00 (one payment) Family (one year) $348.00+$200 each additional-same address Membership fees are due and payable in advance. Monthly payments are due by the 6th of each and every month. Annual members are eligible for discount benefits. PIN_______________ (4-6 digits to access lock) Payment Method: _______ Cash _______ Check (Make checks payable
to _______ Credit Credit Card Number _____________________________________ Name on Card _______________________Expiration Date______ I hereby authorize SSC to charge
my membership fees to the above account. ____________________________________________________________(signature) MEMBER INFORMATION AND RULES Membership at SuperDog is a training
pass that entitles the member access to the facility and equipment
for personal training purposes. Membership
is for the named member only and entitles the named member to train
one or more dogs. SuperDog
management has the right to terminate a SuperDog membership.
The rings and equipment of the facility are available for training
at anytime unless a SuperDog class or event has been scheduled. All Minor members must be accompanied by
an adult with the exception of scheduled class participation. RULES OF OPERATION Members please sign in! Guests with dogs $10 – please sign in! Dogs. It is your responsibility to control your dog(s) while on the SuperDog premises.
Pooper-scoopers and/or bags are provided for your convenience.
Please dispose of dog waste in the container outdoors. If your dog eliminates inside the building,
please use the provided cleaning supplies to THOROUGHLY clean the
entire area. If you or your
dog damages a piece of equipment, please contact Debbie Owen or Marilyn
Donlon as soon as possible. Training. When in the building each person is responsible
for his or her own safety and the safety of his or her dog(s). You work at your own risk and SuperDog is not
liable for any accidents. Some
contact equipment is extremely heavy and should not be adjusted when
alone. It is advisable to bring a cell phone for emergencies.
Please be considerate and take turns using ring time.
Please limit your training time to fifteen- minute sessions
during peak periods. Absolutely no private instruction by members
or guests. Leaving. Please turn off marked lights at the breaker
box in the right rear corner of the work floor.
NO SMOKING PLEASE! I agree that if my membership
application is accepted for training at The terms of this agreement apply
to the current period of training and all subsequent classes/training/events
in which I hereafter participate. I have read and understand these membership
rules and rules of operation and I will abide by them Signed ______________________________
Date ___________________
SUPERDOG, LLC
RELEASE OF LIABILITY This agreement made and entered into by and
between __________________________ (“Participant”) and SuperDog,
LLC (“SuperDog”), on this the _____ day of
____________, 200__. In consideration of SuperDog
granting permission to the Participant for the purpose of using SuperDog’s facilities to include but not limited to dog training,
exercise, show and instruction, the Participant acknowledges that he/she
is in good health and is not and will not be under the influence of
any alcohol or other drug or medication, prescribed or otherwise, which
would impair his/her ability to perform these activities in a safe and
careful manner. The Participant
agrees to act in a safe and responsible manner at all times to avoid
injury to the Participant and to others and to be aware of the risks
inherent in dog training, exercise, show and instruction activities
to the best of Participant’s ability. SuperDog and its instructors
or agents shall not be liable for any sickness, disease, theft or injury
which may be suffered by the Participant or Participant’s dog(s) or
any other cause of action whatsoever arising out of or connected in
any way with Participant’s present or future use of SuperDog’s
facilities. This includes, but
is not limited to, any personal injury or disability that either the
Participant or dog(s) may receive while on Super Dog’s premises. The Participant understands that all risks connected
with the present and future use of, including contact with the dog(s)
upon, SuperDog’s premises are to be borne
by the Participant. The Participant
understands that there are inherent risks of dog training, exercise,
show and instruction activities including, but not limited, to: (a) the propensity of a
dog to behave in ways that may result in injury, harm or death to persons around them; (b)
the unpredictability of the reaction of a dog
to sounds, sudden movement, and unfamiliar objects, persons, or other animals;
and (c)
the potential of a Participant to act in a
negligent manner that may contribute to injury to the Participant or others, such
as failing to maintain control over a dog or not acting within
his or her ability. Participant acknowledges that he/she has a full
and complete understanding of the risks involved in the sport of dog
training, exercise, show and instruction and thereby agrees to accept
such risks and to defend and hold SuperDog
and its instructors and agents harmless from any present or future claim
or loss, disappearance, theft, damage, injury or death whether or not
such injury or death resulted directly or indirectly from the negligent
acts or omissions of said SuperDog or its
instructors or agents. And, should
Participant be a minor child, the parent of said minor child agrees
to assume all responsibility for said child both present and future
while on the SuperDog’s premises and fully acknowledges and agrees to accept
the risks involved. _____________________________________________ PARTICIPANT – PARENT OR GUARDIAN IF PARTICIPANT IS UNDER 18 YEARS
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