AK-9 PRO SPORTS
Membership Application / Renewal
Name : _________________________________________________________________
Address : ______________________________________________________________
City __________________ State _________ Postcode __________
Phone : Home _________________ Mobile __________________
E-Mail : __________________________________
Club Name ________________________________
Dogs Name _________________________________ Breed _________________
Age __________ Titles _____________________________________________
Date of last Vaccinations : / / ( for additional dogs supply these details
on the back of printed page and write number of dogs here............ )
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
Membership Fees :
New Individual $75.00 _ _ _ Renewal Individual $50.00 _ _ _
New Family $125.00 _ _ _ Renewal Family $100.00 _ _ _
* Print out this page , 1 per person,
complete, pay using PayPal, then return completed form
to :
A.McCallum
2070 Namoi River Rd
Manilla NSW 2346
After June 1st Single $60
Family $100