HERDING RELEASE and STUDENT INFORMATION
Name:____________________________________________________________
Address:__________________________________________________________
City, Zip:__________________________________________________________
Day Phone:______________________________________________
Eve. Phone:______________________________________________
Mobile Phone:____________________________________________
Email:__________________________________________________
Please list dog(s) call name, age, sex, and breed, and level of training, previous training, etc.
By signing the form below, I agree to pay for all damages caused by my dog(s). I also agree that Karen
Wessinger. Quality Dog Training, GemStar Ranch, and/or Al Glodan shall not be held liable for any damage
and/or injury to me or my dog(s) or any dog(s) under my control while attending herding and/or dog training
lessons and classes. I agree to pay for replacement cost of sheep or veterinary care for any and all sheep my
dog injures. Replacement cost of sheep is $200.00 per head.
Print Name(s)1):_____________________________________________
2:(_______________________________________________
Signature(s): (1)_________________________________________ Date:____________________
(2):_______________________________________________ Date:____________
Name:____________________________________________________________
Address:__________________________________________________________
City, Zip:__________________________________________________________
Day Phone:______________________________________________
Eve. Phone:______________________________________________
Mobile Phone:____________________________________________
Email:__________________________________________________
Please list dog(s) call name, age, sex, and breed, and level of training, previous training, etc.
By signing the form below, I agree to pay for all damages caused by my dog(s). I also agree that Karen
Wessinger. Quality Dog Training, GemStar Ranch, and/or Al Glodan shall not be held liable for any damage
and/or injury to me or my dog(s) or any dog(s) under my control while attending herding and/or dog training
lessons and classes. I agree to pay for replacement cost of sheep or veterinary care for any and all sheep my
dog injures. Replacement cost of sheep is $200.00 per head.
Print Name(s)1):_____________________________________________
2:(_______________________________________________
Signature(s): (1)_________________________________________ Date:____________________
(2):_______________________________________________ Date:____________
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