Fill out and send the form below, along with a check made payable to LGRC, Inc. to: Bonnie Rubin, 631 Maple Ave., Southampton, PA 18966
For approximate ring time, fill in your email address below or send a SASE along with your check.
Limited Entries CGC, CGCA & Bright and Beautiful Therapy Dogs Test $15.00
Handler Name__________________________
Dog’s Call Name____________________ Breed____________________
Address__________________________________________________________
Canine Good Citizen Test| TDI Test | Tricks Dog Novice/ Intermediate/ Advanced | Novice Open Utility Rally
Class___________________________ Jump Ht._____
Phone____________________
EMail Address____________________________________
AMOUNT ENCLOSED $ ________________
ADDRESS:
K9JYM
252 Bethlehem Pike Colmar, PA 18915
Telephone: (215) 8228840
Southbound Rt 309 & Advance Ln. 1st driveway south of traffic light (Next to ALL STAR CARWASH) Colmar (Hatfield), PA 18915 LANDMARKS:
Zoto's Diner same side as us 8/10s mile north Bergey's Chevrolet same side as us, less than 1/10 mile north at Trewigtown Road intersection Produce Junction same side as us, less than 1/10 mile south Railroad Crossing Colmar SEPTA Station (Walnut St & 309) = half mile south on 309
I (we) agree to hold Lenape Golden Retriever Club its members, directors, officers, agents, employees, instructors, and volunteers 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 my (our) dog(s) while in or upon the premises or grounds used for classes or other club activities or near any entrance thereto, and I (we) personally assume all responsibility and liability for any such claims, and I (we) further agree to hold the aforementioned parties harmless from any claim for loss of my (our) dog(s) by disappearance, theft, death, or otherwise. I (we) hereby assume the sole responsibility for and agree to indemnify and save the aforementioned parties harmless from any and all loss and expense (including legal fees) by reason of the liability imposed by law upon any of the aforementioned parties for damage because of bodily injuries, including death at any time resulting therefrom, sustained by any person or persons, including myself (ourselves), or on account of damage to property, arising out of or in consequence of my (our) attendance at classes or participation in other club activities.
Signature________________________________________
Date__________________ |
