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Membership Form
Please fill out membership form and go to:
https://squareup.com/market/dixie-dock-dogs
to pay for your membership. You may also pay with your DIXIES: which are earned by volunteering at events.
Dixie DockDogs is a volunteer based organization. As such, membership into Dixie DockDogs means you are committed to actively volunteering for the club events, practices, dockdog 101s, committees and /or governing board to ensure the success of our club.
Name
First
Last
Unique ID
Multiple Choice
New Member
Renewal (Due March. 1st)
Name
First
Last
Phone
###
-
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-
####
Phone
###
-
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Email
Email
Address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Aruba
Bahamas
Barbados
Belize
Canada
Cayman Islands
Cook Islands
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Cuba
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Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Nicaragua
Panama
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kosovo
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei Darussalam
Myanmar
Cambodia
China
East Timor
Hong Kong
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Palestine
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
DDD T-Shirt Size (new members only)
1 T-Shirt Per Membership
Dog(s)
Name
Breed
Age
Dog 1
Dog 2
Dog 3
Choose Membership Type
*
Single: $40 Includes one handler
Family: $50 Includes members of the immediate family
Youth: no charge (if no other family members are involved in jumping with the club)
Text Grid
Name
If Youth Handler, Age
1
2
3
4
5
6
Waiver of Liability for Membership in Dixie Dock Dogs
I, the undersigned, have requested the right to participate in Dixie Dock Dogs club events and activities. I understand and acknowledge that I am aware of the inherent danger and risks in the participation of the club and its events where canine activities are occurring. In consideration for permitting participation in such activities, I hereby
waive and release Dixie Dock Dogs, its officers and directors, volunteers, sponsors, donors, hosts and any/all others from all claims, rights or causes of actions accruing in my favor as a result of personal injuries, loss or damage of property (including those my canine(s) caused) during training or activity in conjunction with the club and such waiver and release shall apply on behalf of myself and all who may hereafter claim through or for me.
My signature also indicates that I understand and agree that I am responsible for any and all damages caused by me and/or my canine(s), including but not limited to, property damage and/or injuries to individuals and/or their canine(s) during activities associated with the club or any events or activities of such. I acknowledge that my dog(s) attending and participating in Dixie Dock Dogs events, including practices and social events, are current on all state and/or county required inoculations and vaccinations and have no known aggressive tendencies. I acknowledge that a copy of Dixie Dock Dogs By-laws will be provided for me upon request.
Accept Above Terms
Submitting this form indicates you have read and accept the waiver of liability.