Class Registration

TO REGISTER FOR A CLASS ONLINE: Three steps are necessary :

  1. You must complete this form and press the Submit button.
  2. You must get your payment to the class coordinator. You can either use PayPal or Class Certificates or mail a Check directly to the coordinator.
  3. You must have current vet records (parvo, distemper, and rabies) on file with the club or provide a copy via mail or email to the appropriate coordinator.

On this Form use of the Submit button means I agree to be bound by the "Agreement" below.

I agree by my signature to hold 4RK9's, its members, directors, officers, the owner of the premises used for training, and any party or employee of the aforementioned parties, harmless from any claim or loss which may be alleged to have been caused directly or indirectly to any person, animal or things by this dog while in or upon the premises or near the entrance thereto.

I personally assume all responsibility and liability for any such claim. I further agree to hold aforementioned parties harmless for any such claim for the loss of this dog due to disappearance, theft, damage or injury or any other causes. I am solely responsible for my children's safety and welfare as well as their supervision during the entire time they are present on the training grounds.

To the best of my knowledge this dog is free of any contagious or potentially contagious diseases.

Nosework Class Registration

Class Coordinator :

Class Date & Title :  

Handler's Name :     Dog's name :  

Street Address :

City :  State :  Zip :

Phone Number : Email address :   

Most instructors prefer an e-mail address for communication with students pertaining to the class and for class confirmation. Please indicate if you require telephone.

Breed : Date of Birth : Male Female    Spay/Nuetered? 

What do you hope to accomplish through this class?

What previous dog training experience do you and/or your dog have (recent classes taken)?

Have you previously shown in a trial or plan to? If planning to soon, where and when?

How did you find out about this class?

Check here if you wish to receive email information from the club at the conclusion of this class


If your dog's Vet records are on file with the Club you can make the appropriate selection below. Otherwise you MUST provide a copy of your rabies and distemper combo (distemper and parvo) vaccination together with this form regardless of how many previous classes you have attended at 4RK9s. This information is required by regulations of the State of Iowa.

Most recent Rabies Vaccination Date Date Next Due

Most recent Distemper & Parvo virus Vaccination Date Date Next Due

if unsure of fee, check Class Description
Class Member Price Non-Member or
Inactive Member Price
6 Hour Class  $90.00 $120.00
4 Hour Class $60.00 $80.00
Amount to Remit : $

Select Payment Method :
Class Certificates

After Submitting this form arrange to get your Certificates to Coordinator.
For PayPal Payment -
After Submitting this form you must click the 'OnLine Payment' Button or contact coordinator to arrange payment.
For Check Payment -
After Submitting this form send check to:
 4RK9s Nosework Coordinator
PO Box 488
Central City, IA 52214

Select Vet Records Method :
I will email
I will send via USPS
Records are on file.

Emailing Vet Records -
After Submitting this form you must email your Vet Records to the Class Coordinator :
Sending Vet Records via USPS -
After Submitting this form send Vet Records to:
 4RK9s Nosework Coordinator
PO Box 488
Central City, IA 52214

I have read the Agreement at the top of this form and I agree to the conditions called out.