Obedience Workshop Obedience Workshop Name(Required) First Last Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email(Required) Phone(Required)Dog's Call Name(Required) Breed(Required) Level Dog is Working(Required) Novice Open Utility Problem-Solving Workshop with Ann Marie Scripko(Required) 2 Day Working Spot $225.00 2 Day Audit Spot $150.00 OTCPBC is proud to present this Workshop. Date: February 22-23, 2025 9:00am -4:00 pm Lake Park, FL 33403 Are you a qualifying member? Did you work the required volunteer hours within the last 12 months?Untitled(Required) Yes No Please check yes in this field ONLY if you are entitled to membership discounts. (ONLY OTCPBC MEMBERS WHO HAVE WORKED 20 HOURS at OTCPBC functions within the last twelve months are eligible.) If you do not, you will be charged the nonmember rate. New members are NOT eligible for discounts until they have worked 20 volunteer hours. Discounts apply when volunteer hours have been recorded and published in Lead Lines.Member Discount(Required) Price: $0.00 Total Hold Harmless True and Accurate and Signature(Required)In case of accident or injury to my dog or myself, including dog bites, I hold harmless Obedience Training Club of Palm Beach County (OTCPBC), its instructors, and its Board of Directors, from any claim or liability resulting from said accident or injury. I understand that animals, including my own dog(s), are unpredictable and that dog sports by nature are not without risk. I state that at this time both my dog and I are symptom free of any communicable diseases. By entering this seminar, you release the Obedience Training Club of Palm Beach County of any liability relating to Covid-19 or Canine Influenza or any other human or canine communicable diseases. All AKC, CDC, State and County Covid-19 policies will be strictly enforced.Are you ready?(Required) Yes, I am ready Not ready All information is correct and complete. I have my credit card or PayPal account information handy and am prepared to enter it now. Do not hit submit if you are not prepared to pay at this time.CAPTCHANameThis field is for validation purposes and should be left unchanged. Δ