National Network of Canine Detection Services 2015

National Network of Canine Detection Services
2015 SEMINAR REGISTRATION
Submit to: 9934 Allen Parkway South, Olive Branch, MS 38654
Please enroll me in the 2015 NNCDS K-9 TRAINING SEMINAR to be held in Pensacola,
Florida, March 30 – April 2 (Testing April 2).
NAME:
STREET ADDRESS:
CITY:
APT:
STATE/PROVINCE:
TELEPHONE:
ZIP:
(H)
(W)
(C)
EMAIL ADDRESS:
ORGANIZATION AND ADDRESS:
THE CLASS I WANT IS: (Please indicate)
□
Air Scent
HRD-Land
Advanced HRD-Land
HRD-Water
Tracking/Trailing
I am interested in learning more about the following certifications (additional fees apply):
□
Air Scent
HRD-Land
Advanced HRD-Land
I am interested in becoming an Officer:
I am interested in becoming an Instructor:
□
Air Scent
HRD-Land
YES
YES
Advanced HRD-Land
HRD-Water
Tracking/Trailing
NO
NO
HRD-Water
Tracking/Trailing
On-site Registration and Reception will be on Sunday March 29th and classes will begin Monday
March 30th. Lunches will be provided Monday through Thursday and the closing meal and auction
will be Thursday April 2.
REGISTRATION FEES: Seminar and meals will be $300.00 U. S. currency. Add $100 for each
additional dog that will participate in class sessions. Please list each participating dog.
Deposits of $100.00 will be accepted with the balance of registration fees due on or before March
2, 2015. NO REFUNDS will be made after March 1 without Board Approval. Governmental
Purchase Orders are acceptable.
ONSITE REGISTRATION: Registrations will be accepted up to the day of the seminar, space
permitting, but a late fee of $30.00 will be assessed on registrations received after March 2, 2015 and
space must be confirmed with the seminar chairperson.
DOG REGISTRATION
(This section must be completed in addition to the regular registration form by those bringing a K-9)
Your name:
Complete the following for each dog you bring. You must also provide a copy of each dog’s current
inoculations record (distemper, parvo, adeno, rabies, corona virus, bordetella, etc). We strongly
suggest that your canine be on heartworm medication, plus flea/tick control.
Dog’s name:
Breed:
Age:
Specialty:
RELEASE AND COVENANT NOT TO SUE
I,
, the undersigned, having
requested the right to participate in the seminar, which to be held, in Pensacola, Florida from March
30 to April 2, 2014, such application having been made on my own initiative and acknowledging that
I fully understand that I am aware that there are inherent dangers and risks in the training and
evaluation of Working Canines and Search Dogs, and in the area in which the training is held, and I
fully understand that if I am to participate in the Seminar I accept the inherent dangers and risk to
myself, my dog and to any of my equipment.
In consideration for permitting me to participate in such training or activities, I hereby waive and
release the Officers, Agents, Instructors, Members, Departments, and their staffs of the following
described organizations: The NATIONAL NETWORK OF CANINE DETECTION SERVICES,
otherwise referred to and known as NNCDS; the KlaasKIDS Foundation and the KlaasKIDS Search
Center for Missing and Trafficked Children. I also release any land owner, on whose premises training
or activities may occur, and/or any Organization, Group, or Helpers, by whatever name, from all
claims, rights, or causes of action accruing in my favor as a result of personal injuries or loss or
damage of property including to my dog caused by or during such training or activities in connection
with the Seminar, March 30 to April 2, including arrival and departure dates and such waiver and
release shall apply on behalf of myself and all who may claim through or for me.
DATED THIS
DAY OF
, 2015.
Signature of Applicant:
I,
, the undersigned, understand
and agree that I am responsible for any and all damage caused by my dog, including, but not limited
to, property damage and or injuries to other dogs during activities associated with the seminar
scheduled for March 30 – April 2, 2015, (including arrival and departure dates) at and about
Pensacola, FL.
DATED THIS
Signature of Applicant:
DAY OF
, 2015.