Oriole Dog Training Club Sign-In (version 6)
*** Policies were revised on 7/29/2021 for known COVID-19 exposure for both vaccinated and unvaccinated individuals. If you didn't receive the club email for this change, please read section 1 of the policy document at the link below ***
Electronic version of the Oriole Dog Training Club Sign-In Sheet To Be Used During the SARS-CoV-2 / COVID-19 / Coronavirus 2020 Pandemic.
This sign-in must be completed no more than 24 hours before entering the club building or participating in person in an off-site class or event. ODTC policies concerning building usage during the active SARS-CoV-2 pandemic can be viewed at this link:
By completing this form and clicking on Submit you attest to the accuracy of your answers.
6/30/2021 Update for v6: The waiver has been simplified to refer to the latest policy revisions. Class selections have been updated to match the Summer Catalog
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What is your name?
What activity are you attending? Which class or workshop instructor should review this sign-in form? (Select 'Other" if not entering the building for a class/workshop)
Mon - OB101 - Puppy Kindergarten (Cox, Lavoy)
Mon - OB470 - AKC Rally Runthrus (Long/Shanley)
Mon - AG120 - Agility 3 (Deubler)
Mon - AG300 - Pre-Competition Skills (Gauntt/Deubler)
Mon - ELAG540 - Agility Private with Terry Herman
Tues - OB105A - Basic Obedience (Kramp)
Tues - OB105B - Basic Obedience (Grimm/Hoppes)
Tues - OB110 - Advanced Basic/CGC & Tricks (Anderson/Hoppes)
Tues - OB110A - 3:15pm Advanced Basic/CGC & Tricks (Ruff, R. Bobb)
Tues - EL OB205 - Obed. Run-Thrus All Levels (Meyer)
Tues - OB208 - Novice Foundations, Part 1 (Kaminski, Carlton)
Tues - OB345 - Adv. Open/Begin Utility (O'Carroll/Earwood)
Tues - OB346 - Instructional Novice/Open/Utility Runthroughs (Kaminski/Carlton)
Tues - EL AG535 - Contact and Weave Skills (Paul/Lape/Flagg)
Tues - EL AG536 - Skills and Drills - Novice/Advanced (Herman)
Tues - EL AG537 - Skills and Drills - Masters/Excellent (Herman)
Wed - OB210 - Advanced Novice (Palmer)
Wed - OB340 - Beginning Open (Kavanagh, Fitchitt)
Wed - OB341 - Intermediate Open with Proofing (Kavanagh)
Wed - OB402 - Beginning Utility (Palmer)
Wed - AG050 - Foundations for Dog Sports (Kane/Musser/Ruff/McDowell)
Wed - AG539 - Distance Training (Wilkins)
Wed - ELAG540 - Agility Private with Terry Herman
Wed - NW200 - Beginners NW2/Continuous NW2
Wed - NW300 Beginners/Continuous NW3 (Grskovich)
Thu - FB100 - Beginner Flyball (McGuire)
Thu - FB 300 - Competition Flyball (Fedder/Miller)
Thu - AG100 - Agility 1
Thu - AG110 - Agility 2 (Deubler)
Thu - NW100 - Foundation to K9 Nose Work (Reardon/Tagget)
Thu - NW120 - Foundation/Beginners NW1 K9 Nose Work
Fri - EL OB410 - Beginner Retrieves for Open/Utility (Terry)
Fri - FB310B - Beginner Flyball (Bobb)
Fri - FB310 - Friday Flyball (Bobb)
Fri - EL AG510 - Agility Run-Throughs (Todesco)
Fri - TR105A/B - Beginning Tracking (Hulbert)
Sat - TR115A/B- Beginning Tracking (Eisenberg, Farny)
If you are not entering the building for a class/workshop, provide a short description of the purpose (examples: training, private lesson, cleaning, etc). Otherwise skip to the next section.
I, the undersigned, hereby state that I, to the best of my knowledge, am not infected with the virus SARS-CoV-2 or any other virus known to cause the disease currently referred to COVID-19. I also state that I am free of symptoms of such infection or have tested negative for covid-19 within 3 days after being symptomatic.
I agree with this statement
I cannot confirm I meet any or all of the conditions in this statement
I also hereby agree to contact ODTC if I am diagnosed or show symptoms of SARS-CoV-2 / COVID-19 / Coronavirus 2020 or I have been in close contact for 15 minutes or more with someone diagnosed with SARS-CoV-2 / COVID-19 / Coronavirus 2020 within 14 days of my signature date. The designated contact for Oriole is Rose Kane who can be contacted by email at
or by phone at 443-610-3364)
I have read and understood all of the ODTC policies concerning SARS-CoV-2 / COVID-19 / Coronavirus 2020 and agree to abide by all stated ODTC policies (updated on 07/29/2021) in addition to State and Federal Guidelines concerning the above listed conditions. NOTE: the policies can be viewed at this link:
By choosing option "Yes" below and entering the property located at 9 AZAR COURT HALETHORPE MD 21227, I agree to hold harmless Oriole Dog Training Club, Its Officers, Members and Volunteers in the event of my contracting SARS-CoV-2 / COVID-19 / Coronavirus 2020 or any symptoms .
Finally, I also agree to abide by the current ODTC Hold Harmless agreement regarding Dog Sports and Dog Activities:I agree to hold harmless the Oriole Dog Training Club, Inc., and/or its Officers, Board of Directors, Members, Instructors, ODTC Volunteer Workers, Seminar Presenters and property owners on which classes and workshops are held from any claims or loss, injury or death that may be alleged to have been caused directly or indirectly to me or my dog(s) while participating in the sport of Dog Obedience, Agility, Flyball, Tracking, Conformation, Nosework or other ODTC activities. I personally assume all responsibility and liability when entering the ODTC activities/premises for whatever purpose at my own risk. I hereby warrant that the dog(s) I will train or exhibit are sound, physically and temperamentally, and pose no threat to any other person or dog. I agree that any cause of action, controversy or claim arising out of or related to the entry, exhibition or attendance at any club event between the event-giving club and myself, or as to the construction, interpretation, and effect of this agreement, shall be settled by arbitration pursuant to the applicable rules of the American Arbitration Association.
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