Dallas Dog & Disc Club - Membership Form

About You  

Name (Include Spouse)
Street Address
City, State, Zip
Home Phone
E-Mail address (s)
Web Site address
Children’s names
Other Hobbies
Your Disc Goals	Learning		Fun		Competition Level(s)
(circle all that apply)	What Goals?		Recreation	Don’t know	Local	Regional	Beyond

 Note: Your name, address and home phone number will be listed in the club directory.

About Your Dog(s)

Veterinarian's Name	Veterinarian Hospital	Veterinarian Hospital Phone #

Anything else you would like us to know about you, your family or your dog(s)?

Do you have any talents/contacts that might be useful to the Club? Computer, On Park Board, etc.

 

Waiver of Liability, trademarks and Copyrights (required for membership) In consideration of the training and other Club benefits and for other good and valuable consideration, the receipt and sufficiency of which is hear by acknowledged, I, the undersigned, intending to be legally bound, with regard to myself, my heirs, executors and administrators, do hereby waive and release all rights, claims and damages against the Dallas Dog & Disc Club (the "Club"), its Officers, Directors and other members for any injury or illness incurred by me or my dog at Play Days, performances, competitions and/or any other events associated with the Club. I also attest and can verify my dog’s fitness to participate at said activities and assume responsibility for injury or damage caused by me or my dog to others or their property. Furthermore, I assign to the Club any rights I may have in trademarks and/or copyrights for those items including, without limitation, articles, photos and artwork that I offer for the Club’s use including for publishing via the Club’s Web Site or Newsletter.

Signed                                                                                   Date                                         
(Parent or Guardian if under 18)

T-Shirt size requested with membership kit:
Medium_____   Large_____  Extra Large_____

Mail to:     
Brenda Schmidt
1922 Glen Hill Dr
Carrollton, TX 75007