HANDLER'S SEMINAR REGISTRATION FORM

Handler's Conformation Seminar
Registration Form
Presenter - Valerie Nunes-Atkinson

* Indicates required field

I AM REGISTERING AS: *

Owner/Handler with Dog Junior/Beginner Handler with Dog Auditor without Dog

NAME *

First

Last

E-mail *

Cell Phone *

Home phone *

Emergency Contact: *

Emergency Contact Phone: *

Address *

Line 1

Line 2

City

State

Zip Code

Country

breed *

Dog's Name *

age *

Handler's Option *

Handler Option #1. Please accept my full payment in the Amount of $300. I understand this payment is non-refundable ON/AFTER Sept 1, 2019. Handler Option #2. Please accept my deposit in the amount of $50. This deposit is non-refundable ON/AFTER Sept 1, 2019. I understand the balance of $250 is due on or before August 31, 2019. I also understand if full payment is not received, My reserved slot will be forfeited without reimbursement.

Auditor's Option *

Auditor Option #1. Please accept my full payment in the Amount of $175. I understand this payment is non-refundable ON/AFTER Sept 1, 2019. Auditor Option #2. Please accept my deposit in the amount of $50. This deposit is non-refundable ON/AFTER Sept 1, 2019. I understand the balance of $125 is due on or before August 31, 2019. I also understand if full payment is not received, My reserved slot will be forfeited without reimbursement.

In consideration of my registration to the participation with the said Handling Seminar, I hereby agree to hold harmless AWPGA & Valerie Nunes-Atkinson and associates from any or all claims by myself or any member of my family or any other person(s) accompanying me to the afore said AWPGA or Valerie Nunes-Atkinson or while on the premises and the surrounding area as a result of any injury or action by any dog including my own.

I also waive and release AWPGA & Valerie Nunes-Atkinson and any associates from any and all liability of any nature, for injury or damage which I or my dog(s) may suffer. This includes but without limitation to, any injury or damage resulting from the action of any dog(s). I also expressly assume the risk of any such damage or injury while attending the aforementioned Handling Seminar or while on the premises where this event is being held or the surrounding area thereto.

Release/Waiver *

date *

*PLEASE NOTE:
REGISTRATION FEE (OR DEPOSIT) & REGISTRATION FORM MUST BE RECEIVED
TOGETHER, IN ORDER TO ENSURE YOUR ENTRY RESERVATION.

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Handler's Conformation Seminar​Registration Form​Presenter - Valerie Nunes-Atkinson

Handler's Conformation Seminar
Registration Form
Presenter - Valerie Nunes-Atkinson