About You:
 

Name (Include Spouse)
Street Address
City
State
Zip
Home Phone
Business Phone
E-Mail address(s)
Web Site address
Children’s names
Other Hobbies
Your Disc Goals	Learning		Fun
Competition Level(s)	Local		Regional	Beyond

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

About Your Dog(s)

Veterinarians Name:
Veterinarians Hospital/Clinic:
Veterinarian Hospital Phone  #

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

 

How will you pay?
Pay online with PayPal	Mail a check	With cash

T-Shirt Size Requested with Membership Kit:
Medium    Large   Extra Large

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.

Date:  5/9/2008

By submitting this form, your are officially signing this online document and are agreeing to the above Wavier of Liabilty, that you are representing the person listed in the Name field, and that you are over the age of eighteen.

Mail Checks to:
Dallas Dog & Disc Club
attn: Brenda Schmidt
1922 Glen Hill Dr
Carrollton, TX  75007