1. Required fields have a reddish right-hand border
2. Your Name(required)
3. Email(valid email required)
4. Home Phone(required)
5. Cell phone
6. Work Phone
7. Street Address(required)
8. City, State, Zip(required)
9. Dog's name(required)
10. Breed(required)
11. Sex Male Male-Neutered Female Female-Spayed
12. Dog's age
13. Obedience Class Desired Puppy Kindergarten Family Dog CGC/Therapy Dog Prep All-Around Dog Other
14. Agility Class Desired Intro to Agility Puppy Agility Obstacle Confidence Intermediate Agility Novice Prep Agility Competition Agility Other
15. Team Run Agility Class Desired Handling for Beginning Competition Handling Techniques for Competition Handling for Advanced Competition Focus Class
16. Special (other) class, workshop or seminar
17. Class start date and time(required)
18. Dog's training experience
19. Handler's training/ competition experience
20. Your goals for this class
21. Please list problems you're having with your dog
22. Where did you hear about Mountain View?
23. How will you be paying for your class? PayPal Mail or drop off a check Pay at first class (you may not get in!) (required)
24. By clicking the SUBMIT button, I agree to the following Release and Indemnification: In partial consideration of and as a condition to my exercise of the right to train my dog(s) for obedience or agility upon the property belonging to Kenneth & Averill Ring, located at 766 Viewtown Road, Amissville, Rappahannock County, Virginia, under the auspices of U-NAMIT Inc. DBA Mountain View Dog Training & Agility, I hereby waive, release and discharge any and all claims for damages for personal injury or property damage which I may have, or which may subsequently accrue to me against Mountain View Dog Training & Agility and/or Kenneth or Averill Ring and/or any other person associated with Mountain View Dog Training & Agility, as a result of my activities upon the said property. This release is intended to discharge Mountain View Dog Training & Agility and its agents from and against any and all liability arising out of or in any way connected with such activities, even though that liability may arise out of negligence or carelessness on the part of Mountain View Dog Training & Agility or any person or entity acting on their behalf.

 

cforms contact form by delicious:days

You will be returned to this page after you submit the form. If you plan to pay by PayPal, please click this link after returning to this page.