September 20-23, 2007, Victoria, BC

1. FILL OUT THIS FORM

Name     Phone       

Street    

City    Prov/State   Postal/ZIP 

Email  

WAIT! If my registration is too late (gasp!), please put me on the waiting list in case someone cancels (not only can it happen, it usually does - life takes its toll) 
Yes please!  No, this is a now or never thing

WOOF!  Speak up and let us know about you.  You may use this email form, or a separate piece of paper, or email the answers separately (but be sure we know who you are!)

Tell us about your training background & experience

What are your expectations/goals for this workshop?

If you are bringing a dog, please tell us about the dog

Particular areas of interest

Why are you interested in Suzanne's approach?

When & where have you previously attended a two day seminar with Suzanne?
NOTE:  This is a prerequisite of attending this seminar - no exceptions.

 

Please read and accept the following
Liability Waiver, Assumption of Risk and Hold Harmless

I understand that dog training of any kind is not without risk to myself, members of my family or guests who may attend, or my dog, because some of the dogs to which I (we) may be exposed may be difficult to control and may be the cause of injury or illness even when handled with the greatest of care. I agree I will abide by all safety rules and requests provided by CANINE CHAOS's employees and representatives.
I hereby waive all claims for damages, agree to indemnify, defend and hold harmless, release and forever discharge CANINE CHAOS and their directors, officers, employees, instructors, assistants, heirs, volunteers and representatives from any and all claims, damages, losses or liabilities of any nature arising out of or resulting from 1) my presence at or participation in any training session or other function of Canine Chaos 2) the presence at or participation of any member of my family or any other person accompanying me to said training session or other function while on the grounds of the surrounding area thereto, and 3) any action by any dog, including my own.
I HAVE READ THE ABOVE AGREEMENT CAREFULLY AND FULLY UNDERSTAND THIS AGREEMENT
I accept   I do not accept
 

 

Please note that if you hit the back button you will lose all data typed into the form
[sorry....not sure how to fix this glitch]

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2. SUBMIT this form by clicking Submit form above,  cut & paste it into an email
   (or print it out & mail it in)

3. SELECT A PAYMENT OPTION

          Confirmation will be sent by email upon receipt of payment

Please note that all applications will be reviewed by Suzanne Clothier and that

acceptance/rejection by Suzanne Clothier of any application is final.