Southern Club Trial 29/08/09 entry form
(Licensed Security )
Training Division
Name Mr/Mrs/Ms___________________________________
Dogs Name 1: ____________________________ 2: ______________________________
3: ____________________________ 4: ______________________________
Personal Protection Division
Name Mr/Mrs/Ms___________________________________ Membership No: __________
Dogs Name 1: ____________________________ 2: ______________________________
3: ____________________________ 4: ______________________________
Patrol Dog Division
Name Mr/Mrs/Ms___________________________________ Membership No: _________
Dogs Name 1: ____________________________ 2: ______________________________
3: ____________________________ 4: ______________________________
Read Carefully
This release is intended to discharge K-9 Pro Sports, the owners thereof, and their respective agents and
employees, from and against any and all liability arising out of or in connection with my participation with
K-9 Pro Sports.
I understand that serious accidents can occur during dog training , events and other dog related
activities. Participation in such activities may occasionally result in serious personal injury and / or
property damages. Knowing and appreciating such risks , nevertheless , I hereby agree to assume those
risks and full responsibility for the actions of myself and my dog.
By signing below I acknowledge that I have read , understand and agree to this hold harmless agreement.
____________________________________ ________/________/________
Applicants Signature Date
( Print this page, 1 per competitor , complete and forward to )
A.McCallum
2070 Namoi River Rd
Manilla NSW 2346