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TimestampWhat 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)
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 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 rose.aimee.kane@gmail.com 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: https://odtc.clubexpress.com/content.aspx?page_id=22&club_id=413318&module_id=406009
By choosing option "Yes" below and entering the property located at 9 AZAR COURT HALETHORPE MD 21227, or other designated training locations for an ODTC class, 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.
2
1/1/2023 8:20:05Ken Briefel
Tue - EL AG537 - Mas/Exc Skills and Drills 4:45pm (Herman)
I agree with this statement
YesYesYesYes
3
1/2/2023 8:46:59Karen Albert
Mon - ELAG540 - Agility Private with Terry Herman
Private Lesson
I agree with this statement
YesYesYesYes
4
1/2/2023 14:23:27Pat Parkent
Tue - OB101B - Puppy Kindergarten 10:30am (Lachow)
I agree with this statement
YesYesYesYes
5
1/2/2023 14:24:44Pat Parkent
Wed - AG050 - Foundations for Dog Sports 8:15pm (McDowell, Mihalik, Culp)
I agree with this statement
YesYesYesYes
6
1/2/2023 14:25:54Pat Parkent
Thu - FB110 - Beginner Flyball 7:00pm (McGuire)
I agree with this statement
YesYesYesYes
7
1/3/2023 6:56:18Kara O’Connor
Tues - ELOB205 - Obedience Run-Runthrs (Meyer)
I agree with this statement
YesYesYesYes
8
1/3/2023 13:47:32Robert Reinhardt
Mon - ELAG540 - Agility Private with Terry Herman
I agree with this statement
YesYesYesYes
9
1/3/2023 15:14:47Judy Harding
Tue - EL AG537 - Mas/Exc Skills and Drills 4:45pm (Herman)
I agree with this statement
YesYesYesYes
10
1/3/2023 15:15:14Tom Harding
Tue - EL AG537 - Mas/Exc Skills and Drills 4:45pm (Herman)
I agree with this statement
YesYesYesYes
11
1/3/2023 16:50:32Deb Slaybaugh
Tue - EL AG537 - Mas/Exc Skills and Drills 4:45pm (Herman)
I agree with this statement
YesYesYesYes
12
1/3/2023 16:51:40Laurie McClain
Tue - EL AG537 - Mas/Exc Skills and Drills 4:45pm (Herman)
I agree with this statement
YesYesYesYes
13
1/3/2023 17:16:41Cindy Deubler
Wed - OB341 - Intermediate Open 8:00pm (Kavanagh)
I agree with this statement
YesYesYesYes
14
1/3/2023 17:47:21Allison Machnicki Tue - Agility 3 Handling 6:30pm (Herman)
I agree with this statement
YesYesYesYes
15
1/3/2023 17:47:49Allison Machnicki
Tue - Agility 3 Contacts and Weaves 8:15pm (McClain, Foster)
I agree with this statement
YesYesYesYes
16
1/3/2023 18:30:12Monique Bocock
Tue - Agility 3 Contacts and Weaves 8:15pm (McClain, Foster)
I agree with this statement
YesYesYesYes
17
1/3/2023 21:33:14Terry Herman
Wed - ELAG540 - Agility Private with Terry Herman
I agree with this statement
YesYesYesYes
18
1/3/2023 21:48:53Carolyn Harrison
Wed - ELAG540 - Agility Private with Terry Herman
I agree with this statement
YesYesYesYes
19
1/4/2023 7:43:28Lucas Zmroczek
Wed - AG050 - Foundations for Dog Sports 8:15pm (McDowell, Mihalik, Culp)
I agree with this statement
YesYesYesYes
20
1/4/2023 8:04:18Barbara Novak
Wed - ELAG540 - Agility Private with Terry Herman
I agree with this statement
YesYesYesYes
21
1/4/2023 13:20:19Lorinda McKisson
Thu - AG100 - Agility 1 6:30pm (Deubler, McKisson, Novak)
I agree with this statement
YesYesYesYes
22
1/4/2023 14:22:58Donna M Crozier
Wed - ELAG539 - Distance Training 6:30npm (Wilkins)
I agree with this statement
YesYesYesYes
23
1/4/2023 14:24:53Kimberly Acton
Thu - AG100 - Agility 1 6:30pm (Deubler, McKisson, Novak)
I agree with this statement
YesYesYesYes
24
1/4/2023 14:41:33Jean Wilkins
Wed - ELAG539 - Distance Training 6:30npm (Wilkins)
I agree with this statement
YesYesYesYes
25
1/4/2023 15:48:47Kate Christian
Tues - OB105 - Basic Obedience 6:00 pm (Bethea)
I agree with this statement
YesYesYesYes
26
1/4/2023 16:48:28Kimberly Culp
Wed - AG050 - Foundations for Dog Sports 8:15pm (McDowell, Mihalik, Culp)
n/a
I agree with this statement
YesYesYesYes
27
1/4/2023 16:56:44Karen Keegin
Thu - AG100 - Agility 1 6:30pm (Deubler, McKisson, Novak)
N/A
I agree with this statement
YesYesYesYes
28
1/4/2023 17:48:41 Susan von Suhrke
Wed - ELAG539 - Distance Training 6:30npm (Wilkins)
I agree with this statement
YesYesYesYes
29
1/4/2023 19:33:16Sharon Martinez
Thu - AG100 - Agility 1 6:30pm (Deubler, McKisson, Novak)
I agree with this statement
YesYesYesYes
30
1/4/2023 20:28:48Patricia Pierre
Wed - AG050 - Foundations for Dog Sports 8:15pm (McDowell, Mihalik, Culp)
I agree with this statement
YesYesYesYes
31
1/5/2023 10:35:02Ashley Moriarty
Thu - AG100 - Agility 1 6:30pm (Deubler, McKisson, Novak)
I agree with this statement
YesYesYesYes
32
1/5/2023 10:35:19Allison Machnicki
Thu - AG100 - Agility 1 6:30pm (Deubler, McKisson, Novak)
I agree with this statement
YesYesYesYes
33
1/5/2023 10:35:27Scott moriarty
Thu - AG100 - Agility 1 6:30pm (Deubler, McKisson, Novak)
I agree with this statement
YesYesYesYes
34
1/5/2023 10:36:18Jennifer Hohl
Thu - AG100 - Agility 1 6:30pm (Deubler, McKisson, Novak)
I agree with this statement
YesYesYesYes
35
1/5/2023 10:42:56Charisse Sary
Thu - AG110 - Agility 2 8:15pm (Deubler, McKisson)
I agree with this statement
YesYesYesYes
36
1/5/2023 12:31:43LINDA MILES
Mon - ELAG540 - Agility Private with Terry Herman
I agree with this statement
YesYesYesYes
37
1/5/2023 14:47:58Joseph T. Moran, Jr.
Thu - AG100 - Agility 1 6:30pm (Deubler, McKisson, Novak)
I cannot confirm I meet any or all of the conditions in this statement
YesYesYesYes
38
1/5/2023 14:48:06Vera Glazkova
Thu - AG100 - Agility 1 6:30pm (Deubler, McKisson, Novak)
I agree with this statement
YesYesYesYes
39
1/5/2023 15:01:53Suzanne F. Moran
Thu - AG100 - Agility 1 6:30pm (Deubler, McKisson, Novak)
I agree with this statement
YesYesYesYes
40
1/5/2023 16:15:44Emily Mininsohn Other
Focus class for agility, Novak
I agree with this statement
YesYesYesYes
41
1/5/2023 16:22:33Rachel KleespiesOther
Barb Novak's Focus Class
I agree with this statement
YesYesYesYes
42
1/5/2023 16:30:59Rosemary HanesOtherFocus class
I agree with this statement
YesYesYesYes
43
1/5/2023 16:55:23Nancy MonseauxOtherFocus class
I agree with this statement
YesYesYesYes
44
1/5/2023 17:14:11Janice Cornell
Thu - AG100 - Agility 1 6:30pm (Deubler, McKisson, Novak)
N/A
I agree with this statement
YesYesYesYes
45
1/5/2023 20:03:11Eileen Martin
Thu - AG110 - Agility 2 8:15pm (Deubler, McKisson)
I agree with this statement
YesYesYesYes
46
1/5/2023 20:09:29Allison Battisti
Thu - AG110 - Agility 2 8:15pm (Deubler, McKisson)
I agree with this statement
YesYesYesYes
47
1/5/2023 20:10:07Victoria Herr
Thu - AG110 - Agility 2 8:15pm (Deubler, McKisson)
I agree with this statement
YesYesYesYes
48
1/8/2023 13:33:36Helena Dahlen
Mon - OB470 - AKC Rally Run-Thrus 6:30pm (Long/Shanley/Fitchitt)
I agree with this statement
YesYesYesYes
49
1/8/2023 13:34:52Helena Dahlen
Tues - OB208 - Novice Foundation Part 1 7:00 pm (Carlton/Kaminski)
I agree with this statement
YesYesYesYes
50
1/8/2023 14:43:46Jane Terry
Mon - OB470 - AKC Rally Run-Thrus 6:30pm (Long/Shanley/Fitchitt)
I agree with this statement
YesYesYesYes
51
1/8/2023 15:35:11Barbara Cavelius
Tues - OB105 - Basic Obedience 6:00 pm (Bethea)
I agree with this statement
YesYesYesYes
52
1/8/2023 16:29:13Lisa Stevens
Mon - ELAG540 - Agility Private with Terry Herman
I agree with this statement
YesYesYesYes
53
1/8/2023 16:49:29Maureen Shea
Mon - ELAG540 - Agility Private with Terry Herman
I agree with this statement
YesYesYesYes
54
1/8/2023 17:25:39Brian Rosen
Mon - ELAG540 - Agility Private with Terry Herman
I agree with this statement
YesYesYesYes
55
1/8/2023 20:36:33Debby Brannan
Tues - OB110 - Continuing Basic/CGC & Tricks 6:30 pm (Hoppes)
I agree with this statement
YesYesYesYes
56
1/8/2023 20:37:48Debby Brannan
Wed - OB210 - Advanced Novice 7:00pm (Palmer)
I agree with this statement
YesYesYesYes
57
1/8/2023 20:38:33Debb BrannanTue - Agility 3 Handling 6:30pm (Herman)
I agree with this statement
YesYesYesYes
58
1/8/2023 20:41:29Debby BrannanOther
AG private 1/9 & 1/23 10am Mon
I agree with this statement
YesYesYesYes
59
1/8/2023 20:42:51Bob BrannanOther
AG Priv 1/9&1/23 10am Mon
I agree with this statement
YesYesYesYes
60
1/8/2023 20:43:46Bob BrannanTue - Agility 3 Handling 6:30pm (Herman)
I agree with this statement
YesYesYesYes
61
1/8/2023 20:44:31Bob Brannan
Wed - OB210 - Advanced Novice 7:00pm (Palmer)
I agree with this statement
YesYesYesYes
62
1/9/2023 11:10:33Elaine O’Carroll
Tue - OB345 - Adv Open / Beg Utility 12:15pm (O'Carroll/Earwood)
I agree with this statement
YesYesYesYes
63
1/9/2023 12:49:39cliona odriscoll
Mon - OB470 - AKC Rally Run-Thrus 6:30pm (Long/Shanley/Fitchitt)
I agree with this statement
YesYesYesYes
64
1/9/2023 14:55:43Diane Gilliam
Tue - OB345 - Adv Open / Beg Utility 12:15pm (O'Carroll/Earwood)
I agree with this statement
YesYesYesYes
65
1/9/2023 15:29:57Barry Palmer
Mon - ELAG580 - Advanced Handling 6:30pm (Deubler/Morris)
I agree with this statement
YesYesYesYes
66
1/9/2023 15:31:17Barry Palmer
Tue - OB345 - Adv Open / Beg Utility 12:15pm (O'Carroll/Earwood)
I agree with this statement
YesYesYesYes
67
1/9/2023 15:39:06Cristiane Fitchitt
Tue - OB345 - Adv Open / Beg Utility 12:15pm (O'Carroll/Earwood)
I agree with this statement
YesYesYesYes
68
1/9/2023 17:24:50Glauco lima
Mon - OB470 - AKC Rally Run-Thrus 6:30pm (Long/Shanley/Fitchitt)
I agree with this statement
YesYesYesYes
69
1/9/2023 17:51:02Val Earwood
Tue - OB345 - Adv Open / Beg Utility 12:15pm (O'Carroll/Earwood)
I agree with this statement
YesYesYesYes
70
1/9/2023 19:54:11Rachel Kleespies
Mon - AG300 - Agility PreCompetition Skills 8:15pm (Gauntt)
I agree with this statement
YesYesYesYes
71
1/10/2023 0:04:39Susan Cowles
Tue - OB345 - Adv Open / Beg Utility 12:15pm (O'Carroll/Earwood)
I agree with this statement
YesYesYesYes
72
1/10/2023 0:06:04Susan Cowles
Tues - ELOB205 - Obedience Run-Runthrs (Meyer)
I agree with this statement
YesYesYesYes
73
1/10/2023 9:18:33Carol Carr
Tues - OB105 - Basic Obedience 6:00 pm (Bethea)
I agree with this statement
YesYesYesYes
74
1/10/2023 9:36:01Debbie Kaminski
Wed - OB402 - Beginning Utility 8:00pm (Palmer)
I agree with this statement
YesYesYesYes
75
1/10/2023 10:02:33Dana Hoppes
Tue - OB101B - Puppy Kindergarten 10:30am (Lachow)
I agree with this statement
YesYesYesYes
76
1/10/2023 14:02:48Janet bowen
Tues - OB110 - Continuing Basic/CGC & Tricks 6:30 pm (Hoppes)
I agree with this statement
YesYesYesYes
77
1/10/2023 14:03:56Kate Christian
Tues - OB105 - Basic Obedience 6:00 pm (Bethea)
I agree with this statement
YesYesYesYes
78
1/10/2023 14:13:06Sara tagget
Mon - ELAG580 - Advanced Handling 6:30pm (Deubler/Morris)
I agree with this statement
YesYesYesYes
79
1/10/2023 14:14:01Sara tagget
Tues - OB110 - Continuing Basic/CGC & Tricks 6:30 pm (Hoppes)
I agree with this statement
YesYesYesYes
80
1/10/2023 14:15:08Sara tagget
Wed - NW301 - NW2 K9 Nosework 6:00pm (Reardon)
I agree with this statement
YesYesYesYes
81
1/10/2023 14:15:51Sara tagget
Wed - NW401 - NW3 K9 Nosework 6:oopm (Reardon)
I agree with this statement
YesYesYesYes
82
1/10/2023 15:30:09Liz Miller
Mon - AG300 - Agility PreCompetition Skills 8:15pm (Gauntt)
I agree with this statement
YesYesYesYes
83
1/10/2023 16:23:51Beth Pointer
Tues - OB105 - Basic Obedience 6:00 pm (Bethea)
training
I agree with this statement
YesYesYesYes
84
1/10/2023 16:28:46
Courtney Pierson - Hoppes
Tues - OB110A - Continuing Basic/CGC & Tricks 6:15 pm (Hoppes/Brannan)
I agree with this statement
YesYesYesYes
85
1/10/2023 16:32:40Pilar Gimenez
Tues - OB110A - Continuing Basic/CGC & Tricks 6:15 pm (Hoppes/Brannan)
I agree with this statement
YesYesYesYes
86
1/10/2023 16:44:30Denise McHarg
Tues - OB110A - Continuing Basic/CGC & Tricks 6:15 pm (Hoppes/Brannan)
class
I agree with this statement
YesYesYesYes
87
1/10/2023 16:47:48Denise McHarg
Tue - Agility 3 Contacts and Weaves 8:15pm (McClain, Foster)
class
I agree with this statement
YesYesYesYes
88
1/10/2023 17:06:33Morgan Ward
Tues - OB105 - Basic Obedience 6:00 pm (Bethea)
I agree with this statement
YesYesYesYes
89
1/10/2023 17:30:48Rosemary Hanes
Mon - AG300 - Agility PreCompetition Skills 8:15pm (Gauntt/Hanes)
I agree with this statement
YesYesYesYes
90
1/10/2023 17:33:10Dawna Andrews
Mon - ELAG580 - Advanced Handling 6:30pm (Deubler/Morris)
I agree with this statement
YesYesYesYes
91
1/10/2023 17:54:50Sheila Mehring
Tues - OB105 - Basic Obedience 6:00 pm (Bethea)
I agree with this statement
YesYesYesYes
92
1/10/2023 17:55:11George Mehring
Tues - OB105 - Basic Obedience 6:00 pm (Bethea)
I agree with this statement
YesYesYesYes
93
1/10/2023 18:06:58Jasmine Carastro
Tues - OB110A - Continuing Basic/CGC & Tricks 6:15 pm (Hoppes/Brannan)
I agree with this statement
YesYesYesYes
94
1/11/2023 11:00:42Janet Gauntt
Mon - AG300 - Agility PreCompetition Skills 8:15pm (Gauntt/Hanes)
I agree with this statement
YesYesYesYes
95
1/11/2023 11:11:28judith eargle
Wed - ELAG540 - Agility Private with Terry Herman
private lesson
I agree with this statement
YesYesYesYes
96
1/11/2023 20:34:12Felicitie Bell
Thu - ELAG585 - Focus/Connection/Impulse Control 4:45pm (Novak)
I agree with this statement
YesYesYesYes
97
1/12/2023 9:49:59Sara tagget
Thu - NW102 - Intro to Odor/Birch/K9 Nose Work 6:00pm (Tagget/Cox)
I agree with this statement
YesYesYesYes
98
1/12/2023 9:50:42Sara tagget
Thu - NW201 - ORT/NW1 Preparation 6:00pm (Tagget/Cox)
I agree with this statement
YesYesYesYes
99
1/12/2023 9:51:21Sara tagget
Thu - FB300 - Competition Flyball 7:30pm (Fedder/Miller)
I agree with this statement
YesYesYesYes
100
1/12/2023 11:45:45VERA GLAZKOVA
Thu - AG100 - Agility 1 6:30pm (McKisson/Novak/Sorgenfrei)
I agree with this statement
YesYesYesYes