Liability Release Form

Larry Painter Herding Dog Clinic


Phyllis Clark of All-Breed Herding is offering a 2 day-long weekend Herding Dog Clinic, conducted by Mr. Larry Painter, beginning Saturday, August 11, 2012 at 8:00 AM.   Mr. Painter will work with each individual handler and their dog using facilities and sheep and/or ducks provided at Pete and Phyllis Clark's farm.
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The clinic will be limited to 12 participants, so please confirm your reservation by completing and signing this form accompanied by a check for $100 per day payable to Sunny DeYoung and mail to:

Sunny DeYoung
1134 Rustic Road 4
Glenwood City, WI 54013

First Name:                                                      Last Name:
Address:                                                          City:
State:                                                               Zip Code:
Telephone:                                                       Email:
Dog Name:                                                      Breed:
Training goals or questions:




Liability Release: I accept the risks and hazards in herding dog training and the farm environment. I agree to
RELEASE, HOLD HARMLESS, and INDEMNIFY Pete and Phyllis Clark, and their employees, volunteers and agents from all claims for any injury or damage resulting from any cause, including negligence, while participating in Herding Dog Clinic activities and while using their farm facilities, livestock, and equipment.  

In the event that my dog injures the stock, I agree to pay the veterinary bills for said injury. In the event of death of the stock, the value of the sheep has been set at $125 per head, ducks at $25 which I agree to pay to the owner of said stock.



MY SIGNATURE BELOW MEANS THAT I HAVE READ THE LIABILITY RELEASE AND UNDERSTAND FULLY THE CONDITIONS STATED WITHIN THE LIABILITY RELEASE.

Signature:____________________________________Date:________
If you need more information or have any questions, please contact Sunny DeYoung by email at
sunny@briarleabouvier.com or by phone at 715-265-4056.