Membership and Training Application Form

Thank you for your interest in signing up with the Empangeni Dog Club. Please fill in all the required items and note our conditions of this contract.

Between the “APPLICANT” and the “CLUB”

1. All payment by me in respect of the membership and training will be paid in advance. I will not, under any circumstances, be entitled to any refund of payment made by me. Only in special circumstances will extended payment terms be granted.

2. The Club, trainers and participants, shall not be held liable in any way whatsoever for injuries, losses or damages sustained by the undersigned, their family, friends and pets whilst attending and/or participating in training sessions, displays or any other activities held under the auspices of “Empangeni Dog Club”

3. All dogs are required to be in good health with up to date vaccinations, deworming and tick and flea control.

4. Our puppy and beginner courses contain a huge amount of information and many of the issues that we deal with are way beyond the understanding and attention span of children under the age of twelve so, for this reason, we have set a minimum age limit of twelve to be able to enrol, or handle a dog/pup enrolled in any course.

5. I agree to abide by the rules and regulations of the “Empangeni Dog Club”

6.Booking and confirmation of booking is subject to payment deposit of 50% of the total fees and confirmation of your booking will be forwarded to you by email.

Name and Surname *
Please enter your name and surname
Residential Address: Street Number *
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Residential Address: Street Name *
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Residential Address: Suburb *
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Telephone (Home) *
Please enter your home telephone number
Telephone (Business) *
Please enter your business telephone number
Cell *
Please enter your cell number
Email *
Please enter your email address

Name of person that will do the actual training with the dog *
Please enter the name of person that will do the actual training with the dog
Dog's Name *
Please enter your dog's name
Breed *
Please enter the breed
Gender *
Please select the gender
Sterilised *
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Dog's date of birth *
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Last vaccines done *
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Vet's Name *
Please enter your vet's name

Training Venue *
Please choose your venue
Course Name *
Please choose the course name
What do you want to achieve from this course? *
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How did you hear about us? *
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Terms *
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