Junior Membership Application | Wirehaired Vizsla Cl

JUNIOR MEMBERSHIP APPLICATION

Junior Name

Phone

Mobile Phone

Facebook Email (Used for access to the WVCA Members Facebook Page.)

Parent/Guardian Name

Phone

Mobile Phone

Address

City

State

Zip Code

The club may post members' names, emails, & phone numbers on a password protected, Member's only website. Please select from the options below.

Occupation (optional)

Wirehaired Vizslas you own- Please list call name, Sex, DOB, Registered name, and AKC or foreign registration #.

Please describe "other" dog-related interests not listed above.

I am currently:

Judge

Exhibitor

Breeder

None

Are you interested in/considering breeding in the future?

I am new to the breed and would like to learn more about...

Please share special skills you have that may help the club or other areas you would like to help in that are unlisted above.

List current membership in other (AKC) Parent or Local breed clubs, Foreign dog clubs, or Other (Hunt, agility, obedience, etc.):

Have you ever been denied membership or been suspended by the American Kennel Club (AKC) or an AKC recognized Breed or All-breed club? (If yes, please explain below.)

Assumption of Risk and Liability Waiver

Some WVCA events by their very nature are inherently dangerous and involve some degree of risk. I am aware that participating in the Wirehaired Vizsla Club of America’s events may expose me to certain risks and dangers including, but not limited to the hazards of mountainous, aquatic, or wilderness terrain, accident, illness, the forces of nature, and travel to and from the trailhead or point of departure. I am aware that it is not possible to foresee all of the potential hazards of WVCA activities. Each participant in a WVCA activity is responsible for his or her decisions.

To the best of my knowledge, I feel physically and mentally able to assume full participation in the outings of activities in which I will participate. I understand that the Wirehaired Vizsla Club of America is a volunteer organization. In consideration of voluntarily participating in these events or activities, I have and do hereby assume all the risks inherent in these activities and hold harmless the Wirehaired Vizsla Club of America and its agents, tour leaders, officers, and instructors, from and against any and all claims, liability, and demands of any nature, for the acts or omissions of the Wirehaired Vizsla Club of America or its agents, leaders, officers, or instructors.

I understand that the Wirehaired Vizsla Club of America (WVCA) is an American Kennel Club (AKC) affiliated club and by submitting my membership application to the WVCA, I agree to adhere to the WVCA Constitution, By-Laws and Code of Ethics as well as the AKC’s Mission Statement. I have read the WVCA Constitution, By-Laws, Code of Ethics and the AKC’s Mission Statement and agree to abide by them.

BY E-SIGNING BELOW, I AFFIRM I HAVE READ AND UNDERSTAND THE ABOVE STATEMENTS CONCERNING THE WVCA AND AGREE TO THE CONDITIONS THEREIN.

Each member and each household member must sign the WVCA Liability Waiver. A parent or guardian must sign the form with members under 18 years of age. Typing your name(s) below constitutes an e-signature.

Junior Signature

Parent/Guardian Signature

Relationship to Junior