Application for SDA Chattanooga, Tennessee Chapter

The fee for single application is $300.00
Family of two (2) is $350.00
(Each Additional Family Member fee is $50.00)

The above membership fees include both the SDA club dues and the Chattanooga Chapter dues

The Fee is for a one year membership payable to:
SDA Chattanooga, TN. Chapter
Dues must be included with the completed application and may be sent to the following address:

Dennis Tate - SDA 
2107 Tunnel Blvd

Chattanooga, TN  37406

APPLICATION

Dog's Name:    Breed/Mix: 

Sex:    Age: 

Owner's Name:     

Spouse's Name: 

Address:   

City:    State:      Zip: 

Phone - Home:  Work:    Other: 

Email:    New MemberRenewal:

Amount Enclosed:  

I certify that I Have no disciplinary actions in affect against me or pending with the Chattanooga, TN Club and that I will abide by the rules and regulations of the Chattanooga, TN Club's Constitution and By-Laws.  I, hereby, waive and release Chattanooga, TN. Club and their volunteers, members, and directors from any and all liability of any nature for injury or damage which I or my dog may suffer while attending any sessions or any other functions of this training club or while on the training grounds or surrounding areas.  Upon Acceptance of my application, I agree to indemnify and hold harmless Chattanooga, TN. Club and their volunteers, members, and directors from any and all claims of injury or damage by any member of my family or any other person accompanying me to any training session or function of this training facility or while on the training grounds or the surrounding areas.

Signature:____________________________________________  Date: __________

SERVICE DOGS OF AMERICA --MEMBERSHIP APPLICATION

Name(s):     New:   Renewal: 

Address:   

City:     State:     Zip:    

Phone - Home:     Cell:     Other:   

Email:    

Name of SDA Club:    

If a new SDA member, do you have dogs already registered with UKC (Yes)    (No) 
           (If yes, please list the dog's name, UKC number, age, and gender and submit on a separate page.)

Has applicant(s) ever been charged with a violation of animal rights laws?  (No)    (Yes)

Membership applied for:  Individual   Family  Youth

Annual membership dues:  Single adult $300.00, Family of 2 $350.00, Additional family members $50.00

Family memberships are available for two adults in household or an adult and youth in a household.
Youth memberships are available to members under eighteen years of age on the date of joining or the date of renewing his/her annual membership.
Individual memberships are available for adults eighteen or more years of age on the date of joining or renewing membership.

Benefits of SDA membership:

By applying for membership, applicant(s) agree to abide by all rules, regulations, and policies of Service Dogs of America and the United Kennel Club.

Signature(s):______________________________     _________________________________

Date:  ______________________

For Office Use Only:  Member # _____________ Date application received: ____________Expiration: __________

Release of Liability and Indemnification Agreement

This Agreement is entered between SDA Chattanooga TN Chapter , hereinafter (Association) its officers, instructors, employees, assistants, members and agents, whether compensated or not compensated, including the proprietor(s) of the grounds upon which association activities are undertaken and the Applicant identified below (and hereinafter referred to as (Applicant).

Name of Applicant

Birth Date (if under 21 years of age): 

Address: 

City:  State:     Zip: 

Email address: 

In consideration of the Association allowing the above-named Applicant to participate in any and all of its canine socialization, training, and competitive canine event activities, the Applicant and his or her parents or legal guardian, if applicable, agree to be bound by the terms of this Agreement including all of the Articles herein.

Article I

Applicant expressly agrees that the association shall not be liable for any damages arising from personal injuries or property damage sustained by said Applicant before, during, or after association activities or associated canine activities or as a result of said Applicant's use of the facilities and equipment of the association.  For purposes of the agreement, canine activities shall include, but not be limited to, all siciplines concerning dog socialization, dog training, including obedience, protection, tracking, article search, search and rescue, and dog handler education.

Applicant releases the association from any and all liability, claims, demands, actions, or causes of actions whatsoever arising out of any damage, loss, or injury to the Applicant, or Applicant's property, before, during, or after canine activities conducted by the Association.

It is expressly understood that there are risks of engaging in association canine activities including, but not limited to (I) the possibility of a canine behaving in dangerous or unsafe way that may result in injury to a participant, (II) the inability to predict a canine's reaction to training, sound, movements, objects, persons, or other animals, and (III) the possibility of accidental injury by the mere nature of association activities.

Article II

It is understood that at the Applicant's option he or she may select, obtain, and use protective equipment during canine and associated canine activities.  The responsibility to select, obtain, and use protective equipment lies with the Applicant and not the Association.  Under no circumstance will this responsibility be shifted to the Association, its officers, Board members, or other Association members.  This written Agreement takes precedence over any oral representations or statements made to the contrary.

Article III

Applicant also agrees to hold harmless and indemnify the Association for any and ALL DAMAGES, and reasonable attorney fees it may incur as a result of Applicant's intentional or negligent conduct which results in physical injury to another or damage to another's property.  Applicant assumes full responsibility for any and all injuries, or damages to another's property, or any LOSSES, WHICH may occur to ANOTHER AS a result of Applicant's intentional or negligent conduct.

Article IV

Applicant also agrees that the Association shall not be liable for any loss or theft of personal property.

Article V

Applicant forever releases and discharges the Association, its officers and Board members from any and all claims, demands, damages, rights, or actions, present or future, whether the same be known or inknown, anticipated or un-anticipated, resulting from or arising out of said Applicant's use of the Association's facilities or participation in Association activities.

Article VI

Applicant warrants, represents, and agrees that said Applicant is in good physical condition and that said Applicant has no disability, impairment, or ailment preventing him or her from engaging in association activities.

Article VII

This Agreement shall remain valid until expressly revoked in writing by the Applicant and delivered to the Association President.

THIS IS A LEGALLY ENFORCEABLE AGREEMENT.  IF APPLICANT HAS ANY QUESTIONS REGARDING THE LEGAL EFFECT OF ANY TERM OR CONDITION OF THIS AGREEMENT, HE OR SHE IS ENCOURAGED TO DISCUSS THIS MATTER WITH AN ATTORNEY PRIOR TO SIGNING THE AGREEMENT AND PARTICIPATION IN ASSOCIATION ACTIVITIES.

Applicant:  __________________________________________________

Date:  ______________

Guardian signature (if applicable):  _____________________________________________

Association President:  ________________________________________________

Date:  ______________

 

 

 

 

 

SDA CHATTANOOGA CHAPTER

Rules and Regulations

 

Signature: ______________________________________Date: _______________