Membership Application Form

Muncie Obedience Training Club

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Instructions:

Please enter the requested information below and submit when complete.

All required fields (*) must be filled in to submit.

You will be sent to a confirmation page, immediately after submitting your registration form, that contains payment links. Please submit your payment at this time to

First Name

Last Name

Phone Number

Street Address

City

Zip Code

I am in good standing with the American Kennel Club.

Yes No

Please tell us about the dog(s) you are currently training.

Dog #1's Call Name

Dog #1's Breed

Dog #2's Call Name

Dog #2's Breed

Dog #3's Call Name

Dog #3's Breed

Dogs #4 and up

Per the MOTC Constitution, the purposes of MOTC are to teach people to be responsible dog owners and canine companion sports participants, educate the public on safely interacting with dogs, prevention of cruelty to dogs, encouraging registered therapy dog organization activities, and holding canine companion sports events.

How can we count on you to contribute to MOTC's purposes as a member this year? (Choose all that apply)

Teach or assist with classes Help set up and/or clean up at club trials or other events Steward at trials (Obedience, Rally, Scent Work, and/or FastCAT) Help with hospitality for an event (hotel reservations, chauffeuring judges, corresponding with judges, etc) Help with rent-a-rings, matches, and/or open training sessions Help with seminars, speakers, demonstrations, etc Help with website and/or social media (Facebook, Twitter, etc) Help with articles, pictures, etc. for quarterly newsletter Help with club publicity (brochures, public outreach, etc) Help with building and/or grounds upkeep Help with underwriting and/or grant writing Organize Fit Dog outings for the community Other (please list below)

What "Other" items can you help the Club with?

Please summarize your MOTC volunteer activities from the past club year (July 1 - June 30)

Type of Membership (You will be redirected to a confirmation page that will contain payment links.)

Single Membership ($65) Household Membership ($90) Junior Membership ($2) Non-Active Membership (Associate — non-voting)

If you chose a Household Membership, please list the other household member.

Muncie Obedience Training Club Disclaimer (Be sure that you agree with each of the following statements before signing below.)

I agree to indemnify the Muncie Obedience Training Club (MOTC), its instructors, members, and administrators for any costs or liabilities which may incur as a result of my participation in MOTC classes, training, trials, and sponsored events.

I agree to indemnify the owners of any property being used by MOTC for any costs or liabilities which may incur as a result of my participation in classes, training, trials, and sponsored events.

I agree to allow official, club sponsored photographs to be taken in MOTC classes, trials, and sponsored events for publication in MOTC newsletters, websites, social media, marketing, and advertising materials. I agree that I may opt out of any photographs, and it is my responsibility to inform the photographer. It is the responsibility of the photographer to obtain permission from a parent or guardian before taking pictures of any minors involved.

I understand that MOTC promotes the use of positive dog training methods, and that actual or perceived physical mistreatment is absolutely forbidden. Mistreatment consists of physical or verbal abuse including, but not limited to: hitting, kicking, throwing, slapping, strangling with hands, use of feet as corrections, inappropriate use of collar or leash, and screaming or cursing.

By signing below, I acknowledge that I have read the Club Rules and agree to abide by them. I understand that my failure (or that of my guests) to follow the club rules, may result in the loss of my training privileges.

MOTC Member Rules MOTC Building Rules

My typed name below constitutes my electronic signature, which is the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement.

Today's Date

214 E Centennial Avenue
Muncie, IN 47303

(765) 284-2275