QCDTC Obedience/Rally/Conformation
Class Registration Agreement Form

Do NOT use this form for Agility Classes

Classes cost $110 for non-members / $35 for members

Print a copy of this form, attach your check payable to "QCDTC" and mail to:
QCDTC Registrar, c/o Diane Carr 47 Eastern Ave. Elsmere, KY 41018

Note: You must include a shot record, unless you have already submitted one this calendar year.

Class Requested
Start Date





All classes held at 12018 Tramway Drive, Sharonville, Ohio 45241

payment of must accompany this registration.

Owner's Name Phone
Yes No
Handler's Name
Handler's Phone Street Address
City State
Zip Code Email Address
Dog's Name Breed
Dog's Sex Dog's Age
Referred to QCDTC by:    

CLASS CONFIRMATION: CLASSES ARE FILLED ON A FIRST COME – FIRST SERVED BASIS. You will receive confirmation of course availability by email or phone from the obedience registrar once your check & registration form is received. If the class you requested is full, you will be contacted with alternate class dates & times, otherwise your check will be returned at your request.
ATTENTION QCDTC MEMBERS – please MAIL your registration & check to the registrar - do NOT ask her to accept registration materials at the club. You must write separate checks for agility & obedience classes, as these go to different registrars.
CANCELLATIONS AND REFUNDS: No refunds will be given for cancellations made fewer than 14 days prior to the beginning of class. Refunds will be given for cancellations made more than 14 days before the scheduled beginning of class. However, a $15.00 registration fee will be deducted from the refund. Dogs unable to attend class due to health reasons (including bitches in season), verified by a veterinarian, will be rescheduled for another class. .

The owner / trainee hereby agrees that he will not bring, or permit to be brought the dog(s) named above, or any other dog under his control, to any class of The Queen City Dog Training Club, Inc. (QCDTC) or to or upon the premise where such class is being held while such dog has, to the owner’s knowledge, distemper, parvovirus, or other communicable disease or parasites, or shall be exposed to any disease, or shall come in contact with or be kenneled or kept upon premises where there has been any dog which was exposed to any virus within a period of 30 days prior to the day of such contact, kenneling, or keeping, then the owner / handler agrees that he will not bring, permit or cause to be brought such dog to such class, or to upon such premises, until 30 days after such dog has fully recovered from such disease, or until 30 days after such exposure, contact, or keeping.
The owner / trainee further agrees that he will not bring to any class, a dog that is known to be vicious; and further agrees to adhere to the floor rules of QCDTC. QCDTC may, with cause, refuse to admit any dog to any of its classes or premises, and QCDTC may, with cause, dismiss any dog from class or from the premises.
In consideration of the premises and of the opportunity to attend classes of QCDTC, the owner / trainee agrees to hold QCDTC, its officers, directors, members, agents and employees and each of them harmless from any and all claims arising out of or in any way connected directly or indirectly with or caused by: (1) any biting or other action by or on the part of any dog owned by or under the control of the owner / trainee, his agents, or employees while such dog is on the premises or grounds owned or leased by or under control of said club; or at or near any entrance thereto; or in attending the classes of said Club, or (2) the disappearance, loss, theft, or death of or damage or injury to any dog owned or under the control of the owner / trainee, his agents, or employees, whether or not caused, in whole or in part, by negligence or carelessness of said Club, or of its officers, directors, members, agents, or employees, or any of them; and the owner / trainee hereby agrees to assume responsibility and liability for any claims.

Owner's Signature