Class Registration

First Name*

Please type your full name.

Last Name*

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E-mail*

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Phone*

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Age Range*

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Pick A Class*

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Dog's Name

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Trainer's Name

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Dog’s Age

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Dog’s Breed/Type

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Dog’s Color

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Street Address*

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Address Line 2

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City*

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State / Province / Region*

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Zip / Postal Code*

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Country*

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By registering for an Ely Community Education class, I understand that participation is at my own risk. I, my children, heirs, executors, and administrators agree to indemnify and hold harmless the Ely School District, its employees, agents, contributing organizations, officers, representatives, and facilities from any and all claims resulting from any theft, physical injury, death, or pecuniary loss as a direct or indirect consequence of participation in this activity/class. If I am under 18 years old, my parent or guardian agrees to these terms on my behalf.

Liability Waiver*

By checking I signify that I am 18years of age.
By checking this box I signify my agreement to the Liability Waiver statement above. Invalid Input