Registration For Classes

To register you must pay online using credit card or PayPal account. Do not start the registration form unless you have your account information handy so that you may complete the transaction at this time. This form uses PayPal to process your payment. Do not leave the PayPal application until your payment is completed. A spot in class is not secured until payment processing has successfully completed.

Please do not scroll to find a class. The “REGISTER HERE” button brings you to a specific class. Please read the Class Name and Class Start date on the Select a Class dropdown to be sure you are registering for the class for which you intended to register.
If a class is full, you will not be able to submit information for this class.

"*" indicates required fields

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This field is for validation purposes and should be left unchanged.

Class Full

NW Skill Building 515pm is currently at capacity.

Select a Class*

By entering these classes and events, 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 a qualifying member? Did you work the required volunteer hours within the last 12 months?

Yes

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.

Name*

First Last

Address

Street Address Address Line 2 City State ZIP Code

Primary Contact Number*

Home

Work

Cell

Preferred Phone*

Email*

This email will be used in sending confirmation email. Please check for accuracy.

Dog's Name*

Breed*

Color

Sex*

Age*

Date of Last Distemper/Parvo Vaccination or Titer*

MM slash DD slash YYYY

Date of Last Rabies or Titer

MM slash DD slash YYYY

Does your dog have any injuries or medical conditions?

Yes

Explain

Does your dog bark and lunge when on leash and around other dogs? Has your dog ever been in a fight resulting in injury to himself or others?

Yes

Explain

Has your dog ever tried to bite a person or other dog?

Yes

Explain

Name

Name of Emergency Contact

Please list Name of the person to call in an emergency.

Emergency Contact Phone Number

Please list phone number to be used to call or text in case of an emergency.

Consent*

I have read and I affirm and affix my signature below to the Hold Harmless True and Accurate Statement

Hold Harmless True and Accurate Statement I affirm that the information I have entered is correct, including information on my dog’s behavior around other dogs. My dog’s veterinary records will reflect the dates submitted above.
In case of accident or injury to my dog or myself, including dog bites, I hold harmless the Obedience Training Club of Palm Beach County (OTCPBC), and officers, directors and its instructors , from any claim or liability resulting from said accident or injury. I accept responsibility for all litigation and financial obligation arising from any and all loss or liability of any kind, including but not limited to any personal injury or property damage in which I or my dog(s) may be involved.
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.
I agree to abide by the Club’s policies with regard to the appropriate use of the facility and its equipment, control of my dog, and respect for neighboring properties.
By entering these classes and events, 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.

Hold Harmless True and Accurate and Signature*

I affirm and affix my signature to the Hold Harlmess True and Accurate Statement.

Club Class Policies – Sign and Acknowledge Below*

Refunds: Because class size is limited and sufficient time is necessary to contact alternate students, class tuition may only be refunded if notice, in writing or by email, is received seven (7) business days prior to the start date of a class by the instructor or the director. OTCPBC does not offer make-up lessons, private instruction in lieu of group classes, or transfers of monies from one class to another. Seminar fees are nonrefundable unless there is a waiting list.

Date*

MM slash DD slash YYYY

Member Discount

Price: $0.00

Total

Are you ready to submit this form?

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. Registration for all classes must be paid for online using the Debit/Credit Card option at the time of registration. If payment is not successful, a place in class will not be saved and registration will be automatically voided so someone else may register. Please monitor your debit/credit card or PayPal account to be sure that payment was successful.

Payment Method*

American Express

Discover

MasterCard

Visa

Supported Credit Cards: American Express, Discover, MasterCard, Visa

Card Number Expiration Date Security Code Cardholder Name

You may use the drop down to choose to pay with a credit card or with PayPal.

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