Michigan K-9 Challenge Registration Form
Event Timing: October 17-18, 2020
Event Address: Cher Car Kennels, 4215 S. Lowell Road, Saint Johns, MI 48879

One entry form is required for each dog and handler team.
Email address *
Club/Training Group
First Name *
Last Name *
Address *
(Street, City, State, ZIP)
Phone number *
Dog's Name *
Dog's Breed *
Dog's Age *
Class/es Entering
Dogs that place 1st, 2nd or 3rd in Beginner and/or Intermediate level MUST move up to the next higher level the following year. Make sure you are entering the appropriate level of competition. A dog and handler team titled in ANY protection dog sport or competing in high level protection dog sports is NOT a beginner team.
Beginner (Saturday, October 17)
Beginner Entries are FULL
Intermediate (Saturday, October 17) $63
Advanced (Sunday, October 18) $63
Hardest Hitting Dog (Sunday, October 18) $16
Information for decoys: (dog may bite hands, leg biter, etc.)
Agreement to HOLD HARMLESS, WAIVER and ASSUMPTION of RISK.
I certify that I am the actual owner of this dog, or that I am the duly authorized agent of the actual owner.

In consideration of the acceptance of my entry, I agree to abide by the rules and regulations of this event and I further agree that Patrick Riley, Backwoods K-9 LLC, and agents thereof have the right to refuse my entry for cause that the club shall deem sufficient. In consideration of my entry, I agree to hold Patrick Riley, Backwoods K-9 LLC, The Michigan K-9 Challenge, Cher Car Kennels, as well as members, directors, officers, agents, and any employees or representatives of either organization (“RELEASEES”) to be harmless from any claim for loss or injury which may have been caused directly or indirectly to any person or thing by the act of this or any other dog while upon or in the vicinity of the trial premises or grounds, or for any injury or damage to this dog whether they be by disappearance, theft or accident, regardless of the cause of said loss.
I further agree to personally and solely assume all responsibility and liability resulting from participation in this trial and any claim for loss or damage that results from my participation in or observance of this trial.
I acknowledge that there are risks involved in bringing my dog into contact with other dogs, and in my participation in Backwoods K-9 LLC and Michigan K-9 Challenge functions and events including the risk of my dog contracting a communicable disease and the risk of physical injury arising from an altercation with another dog, the condition of the training premises and grounds, and a wide range of other factors.
I also understand that participation in such programs is not without risk to myself, members of my family or guests who may attend, or my dog, because some of the dogs to which I will be exposed may be difficult to control and may be the cause of injury even when handled with the greatest amount of care. While Patrick Riley, Backwoods K-9 LLC., and affiliated organizations may take steps to reduce those risks, I acknowledge that it cannot and does not guarantee that these risks will be eliminated.
I certify the accuracy of all information given about my dog and specifically represents that I am the sole owner or authorized agent thereof, and acknowledge sole responsibility for any and all acts or behavior of my dog. My dog is up to date on vaccinations for Rabies, DHL and Parvo.

I further understand and agree to not use any drug or alcohol before, during or after my attendance or participation in any activity or function on the training grounds or the surrounding area thereto and acknowledge that my participation in such use will result in immediate dismissal from any activity (without refund) and expulsion from the grounds.

In consideration of being allowed to participate in Backwoods K-9 events and activities, I acknowledge, appreciate, and agree that:
1. Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and,
2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,
3. I willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases. If, however, I observe and any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,
4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Backwoods K-9 their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SUBMITTING THIS ENTRY FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.


FOR ATTENDEES OF MINORITY AGE (UNDER AGE 18)
This is to certify that I, as parent/guardian, with legal responsibility for this attendee, have read and explained the provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations for protection against communicable diseases. Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees for any and all liabilities incident to my minor child’s/ward’s presence or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent provided by law.

If you are having any symptoms of illness, we ask that you stay home.
I confirm that: *
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I also confirm that: *
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A copy of your responses will be emailed to the address you provided.
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