Your Name/Votre Nom (required)

Street Address/Rue & Numero (required)

City/Ville (required)

Province or State/Province ou État (required)

Your Postal Code/Votre Code de Postal (required)

Your Telephone/Votre Telephone (required)

Your Email/Votre Courriel (required)

Dog's Registered Name/Nom de Chien (required)

Dog's Call Name/Nom de Chien pour Concours (required)

Dog's Date of Birth/Date de naissance du Chien (required)

Dog's Breed/Race du Chien (required)

Dog's Gender/Sexe du Chien (required)

Dog's Registry & Number/Numero & Inscription de Chien (required)

Dog's Microchip or Tattoo/Puce ou Tatouage de Chien (required)

Your Club & Organization/Votre Club & Organisation (required)

Your Membership Number/Votre Numero de Membre (required)

Dog's Owner (if different than Handler)/Proprietor du Chien (si différente que le conductor

Level/Niveau
---CSAUBrevetRing IRing IIRing III

Recall/Rappeler
---Whistle SifflerVoice Voix

Retrieve Article/Article d'Apporter:
---Socks ChaussettesGloves GantsGlasses Case Etui LunettesHandkerchief Mouchoir

Jump Heights/Sauter des Hauteurs (required)

Payment Method:
---Electronic transferChequeCashPayPal

Payment Amount:
---$100$125 Late Fee (After May 15)

TERMS & LIABILITY: Please read below and check boxes if you agree.

I, the undersigned, understand by signing below that I shall acknowledge risk, waive, indemnify, hold harmless and release from all liability all officers, directors, employees, agents, servants and volunteers of SOAR Ringsport Inc., the Canadian Ringsport Association and the Property Owner(s). I further understand that French ringsport is an inherently dangerous sport for owners, handlers and dogs and that loss, damage or injury to the foresaid can occur caused directly, indirectly or contributed to by the participation in this Trial. I warrant and state that I am solely responsible for the condition, health and adequacy of my dog and me and assume all costs as a result of my participation in this Trial. In consideration of being permitted by SOAR Ringsport Inc. to participate in this Trial, I understand and acknowledge that by signing below, that I am legally agreeing to the statements above and that these statements are being accepted and relied upon by the SOAR Ringsport Inc. and myself. I hereby freely and voluntarily acknowledge and/or take action for myself, and on behalf of my spouse, children, parents, guardians, heirs, next of kin, and any legal or personal representatives, executors, administrators, successors and assigns, or anyone else who might claim or sue on my behalf that I have had the opportunity to consult and obtain independent legal advice prior to signing this waiver and that I am not a person under disability and have legal capacity to consent to the above. Yes, I have read and accept the terms of the above

Signature: (please print name below for an electronic signature)

Date:

Additional Notes: