Training Application If you would like to sign up for a training class, please complete the form below. For questions about our classes, please send us an email at qkc@quincykennelclub.com or call Jane Huelsmeyer at (217) 434-8655. Training Application Name of Owner Phone Address City State Zip Code Email Address Name of Dog Breed Age of Dog AKC Registered AKC Registered Yes No Where did you get this dog from? Does this dog have any present or past illnesses or injuries? Have you ever trained a dog in the past? Have you ever trained a dog in the past? Yes No If Yes, where? How did you hear about our classes? Upload Your Proof of Vaccination Certificates (Optional) You may upload proof of vaccination here (rabies, distemper, etc)File InputChoose FilesNo Files ChosenAccepted file types: jpg, jpeg, jpe, png, pdf. Max. file size: 5 MB I authorize the Quincy Kennel Club to use photographs and videos of myself and/or my dog on the Quincy Kennel Club website and other advertising materials. I authorize the Quincy Kennel Club to use photographs and videos of myself and/or my dog on the Quincy Kennel Club website and other advertising materials. Yes No I have read and agree to the Building Rules I STATE THAT I AM THE OWNER OF THE DOG NAMED IN THE ABOVE APPLICATION, AND THAT SAID DOG IS NOT A MENACE TO OTHER DOGS OR TO PEOPLE. I FURTHER STATE THAT I AM RESPONSIBLE FOR ANY INJURIES TO PEOPLE OR DOGS OR FOR ANY DAMAGE TO PROPERTY CAUSED BY SAID DOG. I UNDERSTAND THAT NO REFUNDS WILL BE GIVEN. Signature (Must be signed by an adult 18 year or older.) Date 11 + 3 = Submit Application
