Please read the following waiver carefully then fill in the form below.
- You may list the names of ALL of the dogs that you own on one form
- If you have a dog that is owned by someone else please fill out a separate form for that dog and have the owner fill out a form agreeing to the waiver as well.
- Be sure to click on the “I agree” box and do the Captcha.
- You will receive an email confirming that your waiver has been received.
Statement of Responsibility and Waiver of Liability
I certify that I am the actual owner of the dog named below, or that I am the duly authorized agent of the actual owner. I (we) certify and represent that the dog entered is not a hazard to persons or other dogs.
I (we) understand that agility is physically demanding sport for both handler and dog. I (we) understand a variety of equipment is used which could result in injury to my dog or me. I (we) understand that I (we) are training/working the dog at my (our) own risk. I (we) understand that it is my (our) sole responsibility to ensure my (our) own safety and the safety of the dog. If at any time I am uncomfortable with the safety of a situation it is my responsibility to notify the instructor/coordinator that I will not be participating in that aspect of the training/practice program.
I (we) agree to hold Deborah Strieter, Top Notch Canines LLC, any person, or business entity associated with Top Notch Canines LLC, including but not limited to those contracted to, volunteering for, employed by Top Notch Canines or any member of their families, harmless from any claim for loss or injury which may be alleged to have been caused directly or indirectly to any person or thing by the act of this dog or myself (us) while in or about the premises or grounds or near any entrance thereto, and I (we) personally assume all responsibility and liability for any such claim; and I (we) further agree to hold the aforementioned parties harmless from any claim for loss, injury or damage to myself (us), this dog, or my (our) personal property whether it is the result of accident, negligence, or any other cause.
I (we) understand that I may not bring guests or children to the premises without the permission of Deborah Strieter or other individual contracted to Top Notch Canines LLC. Guests and guardians of children will be required to sign a liability statement.