AKC Parental Consent Form for Minors Under 13

We collect the following information from participants handler’s name, parental phone number and email address, Region of Agility facility, state of agility facility, Dog registration number, breed, jump height, run information (date, time, faults), Team name and Team Captain name, photos submitted to us, and the like. We collect no other personal data from your child and we will only use this information in order to facilitate your child’s participation in the AKC Agility League including Agility Team and individual dog rankings, for our internal business purposes and in our promotional materials. To learn more, please review our Privacy Statement.

In accordance with the Children’s Online Privacy Protection Act (“COPPA”), AKC requires parental consent for any child under the age of 13 (“Child”) for AKC’s collection, use and disclosure of that Child’s personal information.

Please submit one form per Child, as applicable.

Jump Class & Height for Dog
* Regular dogs will jump at their measured AKC jump height 
* Preferred dogs will jump 4" lower than their measured AKC jump height
* Veteran dogs may jump up to 8" lower than their measured AKC jump height, with a minimum jump height of 4"
Veteran dogs must be 10 years or older

Jump Class & Height for Dog
* Regular dogs will jump at their measured AKC jump height 
* Preferred dogs will jump 4" lower than their measured AKC jump height
* Veteran dogs may jump up to 8" lower than their measured AKC jump height, with a minimum jump height of 4"
Veteran dogs must be 10 years or older

Jump Class & Height for Dog
* Regular dogs will jump at their measured AKC jump height 
* Preferred dogs will jump 4" lower than their measured AKC jump height
* Veteran dogs may jump up to 8" lower than their measured AKC jump height, with a minimum jump height of 4"
Veteran dogs must be 10 years or older

PARTICIPATION, CONSENT, RELEASE AND WAIVER AGREEMENT

I and any minor named below understand that participation in the AKC Agility League may be hazardous to myself, any minor named below, and others that may attend with me and any minor named below. I acknowledge on behalf of myself and any minor named below the risks associated with our respective participation in the event and I have made the affirmative decision to participate on behalf of myself and any minor named below.

In consideration of the acceptance of participation in the AKC Agility Team League (the “League” or “event”) by me and any minor named below, I and any minor named below agree to abide by the rules and regulations of The American Kennel Club (“AKC”), in effect during the time of my participation in the League, and any additional published rules and regulations and any decision made in accord with them. I agree on behalf of myself and any minor named below that the AKC has the right to refuse to allow participation by me or any minor named below as AKC deems sufficient. I certify on behalf of myself and any minor named below that I and/or any minor named below are the actual legal owner(s) of the dog, whose name and information I or any minor named below has entered on the applicable registration form and that the dog is properly vaccinated in accordance with applicable law. I certify and represent on behalf of myself and any minor named below that the dog entered is not a hazard to persons or to other dogs.

In consideration of the acceptance of the participation by myself and any minor named below and of the holding of the League and of the opportunity to participate, I and any minor named below will indemnify, defend and hold AKC and any of its affiliates, subsidiaries, employees, officers, directors, or agents; any judge, judging at this event; the owner and/or lessor of the premises; any provider of services that are necessary to hold this event and any volunteers of the forementioned parties (“Indemnitees”) harmless from (“Indemnify”) any and all claims, costs, liabilities, judgments, expenses or damages (including reasonable attorneys’ fees) (“Costs”) (i) arising out of any breach of this Agreement or any representation I and any minor named below make herein; (ii) any actual or alleged physical damage to tangible property (including the dog identified in the applicable registration form) and/or personal injuries, including death, to any person (including me and any minor named below), or the alleged negligent act(s) or omission(s) or alleged willful misconduct by me or any minor named below. Further, I agree on behalf of myself and any minor named below to hold the Indemnities harmless from any and all claims, costs, liabilities, judgments, expenses or damages including Costs alleged to have been caused directly or indirectly to any person or thing by the act of the dog identified in the applicable registration form while in or about the event premises or grounds or near any entrance thereto, and I and any minor named below personally assume all responsibility and liability for any such claim.

By signing below, I give irrevocable permission to AKC, its affiliates, clients, assignees, and licensees to use the name(s), voice(s), biographical information, performance(s), and likeness(es) (collectively, “name/likeness”) of me and any minor named below and the name/likeness of the dog identified in the applicable registration form and any other materials that the AKC collects from me or that I submit to the AKC in any form or format, including but not limited to photographs, portraits, pictures, electronic or digital images, tape, film, video footage, television, live-stream, recordings, audio-visual materials and all reproductions thereof (all of the foregoing, collectively, “Materials”), completely or in part at the AKC’s sole discretion, including without limitation for any production of AKC and/or is affiliates, its clients, assignees and licensees; to copyright such productions; to distribute such productions publicly in may manner whatsoever including without limitation on promotional and

advertising, and public relations materials, broadcast, print, and electronic materials, and internet websites (including social media sites); and to issue and authorize publicity concerning such productions; all of the foregoing without notice to me or any minor named below.

I agree on behalf of myself and any minor named below that all Materials of me, any minor named below, and the dog identified in the applicable registration form used and taken by or on behalf of AKC at the event are owned by AKC and AKC is the owner of all copyrights in same. I acknowledge on behalf of myself and any minor named below that neither I nor any minor named below have any right, title, or interest in or to the Materials, nor any right to nor any, right, title, or interest in or to any copyright therein. I and any minor named below hereby irrevocably assign to AKC any right, title or interest we may have in the Materials, in whole or in part. If I (we) should receive any print, negative or copy thereof, neither I nor any minor named below shall use or authorize its use by anyone else.

I represent and warrant that AKC’s use of the Materials provided by me will not violate the rights of any third parties. On behalf of myself and any minor named below, I hereby irrevocably release, discharge and hold AKC harmless from and against any and all liability in connection with the use of the Materials, in whole or in part, including without limitation any claims under copyright or other federal law, or any proprietary right under any state law or under the law of any jurisdiction, including any and all laws relating to the right of privacy and/or the right of publicity.

I agree on behalf of myself and any minor named below that the Materials’ use need not be submitted to me or any minor named below for inspection or approval or the use thereof as contemplated herein and that AKC, its affiliates, licensees, agents and assignees and others working for it or on its behalf shall be without liability to me for any distortion or illusionary effect resulting from the creation, publication or broadcast of the event. I acknowledge and agree on behalf of myself and any minor named below that this agreement includes the right of AKC to copy, cut, crop, edit, revise, alter, adapt, modify, or otherwise change and use the Material, in whole or in part, without any further approval by or consideration to me or any minor named below. Any statements that I or any minor named below make will reflect actual experience and honest opinions.

I hereby waive any moral rights, neighboring rights, or rights of publicity that I or any minor named below may have in the Material. I further waive on behalf of myself and any minor named below any and all claims arising under the Visual Artists Rights Act, 17 U.S.C. 106A, and any comparable state or local law, as amended from time to time, with respect to the Materials. I (we) further agree that I (we) shall have no claim to any compensation for any use of the Materials and/or the name/likeness of me, any minor named below, and/or the dog identified in the applicable registration form.

I acknowledge that my personal information, and the personal information of my minor child, may be processed in accordance with the AKC Privacy Statement, located at https://www.akc.org/privacy/.

I (WE) AGREE THAT ANY CAUSE OF ACTION, CONTROVERSY OR CLAIM ARISING OUT OF OR RELATED TO THE ENTRY, EXHIBITION OR ATTENDANCE AT THE EVENT BETWEEN THE AKC AND THE EVENT-GIVING CLUB AND MYSELF (OURSELVES) OR AS TO THE CONSTRUCTION, INTERPRETATION AND EFFECT OF THIS AGREEMENT SHALL BE SETTLED BY ARBITRATION PURSUANT TO THE APPLICABLE RULES OF THE AMERICAN ARBITRATION ASSOCIATION. HOWEVER, PRIOR TO ARBITRATION ALL APPLICABLE AKC BYLAWS, RULES, REGULATIONS AND PROCEDURES MUST FIRST BE FOLLOWED AS SET FORTH IN THE AKC

CHARTER AND BYLAWS, RULES, REGULATIONS, PUBLISHED POLICIES AND GUIDELINES.

THE RELEASE HEREUNDER IS INTENDED TO APPLY TO ALL CLAIMS NOT NOW KNOWN OR SUSPECTED TO EXIST, WITH THE INTENT OF WAIVING THE EFFECT OF CALIFORNIA CIVIL CODE SECTION 1542, WHICH STATES: “A GENERAL RELEASE DOES NOT EXTEND TO CLAIMS WHICH THE CREDITOR DOES NOT KNOW OR SUSPECT TO EXIST IN HIS OR HER FAVOR AT THE TIME OF EXECUTING THE RELEASE, WHICH IF KNOWN BY HIM OR HER MUST HAVE MATERIALLY AFFECTED HIS OR HER SETTLEMENT WITH THE DEBTOR,” AS WELL AS OTHER LAWS REQUIRING PRESENT INTENT TO RELEASE FUTURE UNKNOWN CLAIMS.

By signing below, I hereby represent and warrant that I am 18 years of age or older, have reached the age of majority in my state of residence, and have the right to enter into this agreement and grant the rights hereunder on behalf of myself and any minor named below. I state further that I have read this agreement and that I fully understand and agree with the contents.

This agreement shall be binding upon me and any minor named below and our respective heirs, legal representatives, successors, and assigns.

If applicable:

I hereby certify that I am the parent or guardian of the minor child named below, who is under the age of 18 years, and I hereby consent to the terms set forth above as they apply to the minor under my charge.