[Current Schedule of Classes]

454 N. Farm Road 223, Springfield, MO
(DO NOT MAIL TO THIS ADDRESS--SEE MAILING ADDRESS BELOW)
Applications must be received no later than 2 days before the class start date.
(417) 862-7967
Click here for a MS Word version of this form

Click here to enroll on-line
Application for Training


Application for Training

Class                                                                           
      (check schedule for class prerequisites!)

Class Date                                                                  

Class Time                                                                  

                                                                                     

 

Handler Information

 

Handler                                                                      

Age (if under 18 or over 65)                                      _

Address                                                                      

City                                                                            
State                              Zip Code                              

Phone – home                                                             

Phone – cell __                                                           

Email Address                                                           

Have you trained a dog before?        YES        NO

If yes, where and when?                                            

                                                                                     

How did you hear about SMDTC?

             Student. Who?                                  

             Club member. Who?                         

             Veterinarian. Which one?                             

             Groomer. Which one?                                   

             Kennel. Which one?                                      

             Newspaper

             Drive By - Sign

             Web

             Other. Please list.                                          

 

Dog Information

Breed                                                                         

Name                                                                          
Date of Birth                                                              

Sex                  Neutered?                  

 

Vaccinations, list date last received.  You must bring vaccination records to the first class if not included with application for training.

Rabies                                     DHPP                        

Veterinarian                                                               

Has your dog ever growled or snapped at anyone?                                
 YES        NO

If yes, briefly state circumstances.                             

                                                                                     

                                                                                     

                                                                                     

Has your dog ever bitten any person?
                YES        NO

If yes, briefly state circumstances.                             

                                                                                     

                                                                                     

                                                                                     

Does your dog show aggression or fight other dogs?
                YES        NO

If yes, briefly state circumstances.                             

                                                                                     

                                                                                     

 

Briefly state what you hope to accomplish in training this dog?
                                                                    ________
__________________________________________

                                                                                     

                                                                                     

                                                                                     

                                                                                     

                                                                                     

Please mail your non-refundable class fee and a copy of your vaccination records with this form to the address below:

 

 

Margery West
5143 S Dollison
Springfield, MO  65810
E-mail: enrollment@smdtc.org

 

Make checks payable to SMDTC. See pricing options and discounts at the end of this document.

 

Our classes are limited to 12 dogs.  If this class has filled before your enrollment fee is received, you will be notified and put into another class or your fee returned to you.    

                                                                                   

   


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

As a condition to acceptance of this application, the Agreement to Hold Harmless Waiver and Assumption Risk and the Excusal from Participation Statement must be signed.
 

Agreement to Hold Harmless Waiver and Assumption of Risk

 

I understand that attendance at a dog obedience training class is not without risk to myself, members of my family, guests who may attend, or my dog, because 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 amount of care.

I hereby waive and release the Springfield, Missouri Dog Training Club, Inc. hereafter referred to as SMDTC, its employees, officers, members, and agents from all liability of 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, of SMDTC, or while on the training grounds or surrounding area thereto.

In consideration of and as inducement to the acceptance of my application for training by SMDTC, I hereby agree to indemnify and hold harmless SMDTC, its employees, officers, members, and 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 function of SMDTC, or while on the grounds or the surrounding area thereto as a result of any action by any dog, including my own.

 

Excusal from Club Participation Statement

Each owner and dog are permitted to attend classes and use the facility at the sole discretion of Springfield Missouri Dog Training Club (hereinafter SMDTC).  Each instructor may at his/her discretion remove a dog and/or owner from a class. Incidents occurring outside of classes on SMDTC property as well as incidents occurring at SMDTC sponsored events, may be reported to the Training Director for handling. If the dog or owner is excused from club participation, the owner’s sole recourse is to make a written letter of appeal to the SMDTC Board of Directors, to the attention of the Board President. The decision whether or not to allow further participation of the excused dog and/or owner in SMDTC classes, events, or use of facilities, is at the sole discretion of the Board.

 

                                                ______                        _____
Signature of Owner or Authorized Agent                     Date

  

                                                                        ___________
(Parent or legal guardian if Handler is a minor)             Date

 


                                                                                    _____
Name of Handler (if different from Owner)                Date 
 

 Pricing and Discounts

All 6-week classes are $80

Home Manners and Public Manners classes (7-week classes) are $95

Other classes are as listed on the schedule

            Discounts:

$5 discount for seniors (65+)

$10 discount for dogs adopted from the SW MO Humane Society or a reputable rescue organization upon presentation of an adoption contract. PLEASE NOTE: All dogs must be in the new owner's home at least two (2) weeks PRIOR to the dog attending class.

            Package Pricing:

This pricing is intended for a single dog, and classes must be taken consecutively (not concurrently).
The second class in the package must be taken within a year from the date the package was purchased.


Package 1.
        Puppy Soc 1 (by itself $80) AND:
        Puppy 4-6 mths ($95 each individually) =
                 Package price $155 (saves $20)

Package 2.
        Home Manners OR 4-6 Puppy Home Manners ($95 each individually) AND:
        Public Manners (by itself $95)
                 Package price $165 ($25 savings)

$5 coupon available for students in beginner classes (puppy socialization and home manners) who did not purchase a package and want to take a second course.

No other discounts or coupons may be applied to packaged class purchases.  Only one discount allowed per course.

 

This Page last updated 11/26/2012.  For questions/problems related to the web site, contact admin@smdtc.org).