Oriole Dog Training Club Sign-In (version 3)
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.
What is your name?
What activity are you attending at the building? Which class or workshop instructor should review this sign-in form? (Select 'Other" if not entering the building for a class/workshop)
Mon - ELAG540 - Private with Terry Herman
Mon - AG100 - Agility 1 (Deubler)
Mon - AG110 - Agility 2 (Deubler)
Mon - AG300 - Agility Pre-Competition (Gauntt/Novak)
Tue - OB321 - Transition to Off-Leash (Carlton/Kaminski)
Tue - OB345 - Adv Open/Beg Utility (O'Carroll/Earwood)
Tue - OB105 - Basic Obedience (Kramp)
Tues - ELOB205 - Nov/Op/Util Runthroughs (Meyer/Stevens)
Tue - NW406 - Elite (L Grskovich/Reardon)
Wed - ELAG540 - Private with Terry Herman
Wed - OB210 - Advanced Novice (Palmer/Terry)
Wed - OB340 - Beginning Open (Kavanagh/Fitchitt)
Wed - NW200 - NW1/NW2 (L Grskovich)
Thu - Dogstar Class (Thomas)
Thu - NW300 - NW2/NW3 Intro (D Grskovich)
Thu - NW400 - NW3 (Reardon)
Fri - FB100 - Beginner Flyball (Bobb)
Fri - FB310 - Friday Flyball (Bobb)
Fri - OB101 - Puppy Class (Bobb)
Sat - OB346 - Nov/Op/Util Runthroughs (Griffin/Bresson)
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 including: FEVER, COUGH, SHORTNESS OF BREATH, AND/OR PERSISTENT PAIN/PRESSURE IN THE CHEST. I have also not to my knowledge been in direct contact with anyone diagnosed with SARS-CoV-2 / COVID-19 / Coronavirus 2020 in the last 14 days. In addition, I am not residing in or spending time in an area where an outbreak has been declared.
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 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 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 or conditions related to the listed conditions.
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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