Ontario DockDogs Membership Application

www.ontariodockdogs.com

Handler Information

First Name___________________________:Last Name:_______________________
Street Address:________________________________________________________
City:______________________Province::____________Postal Code:____________
Phone Number(s):______________________________________________________
Email Address:_________________________________________________________
DockDogs Forum Username:_____________________________________________

Other Members of Household

First Name:__________________________ Last Name:_______________________
First Name:__________________________ Last Name:_______________________
First Name:__________________________ Last Name:_______________________

Dog(s) Information

Name:_______________________________________________________________
Breed:_______________________________________Color:___________________
(** If mixed breed, please list probable breed heritage**)
Male/Female Date of Birth (mm/dd/yyyy):______________________

Name:_______________________________________________________________
Breed:_______________________________________Color:___________________
Male/Female Date of Birth (mm/dd/yyyy):______________________

Name:_______________________________________________________________
Breed:_______________________________________Color:___________________
Male/Female Date of Birth (mm/dd/yyyy):______________________

Signature:_____________________________________Date:_______________________

Membership Dues for 2009: $25 per handler (unlimited dogs) or $50 per household (unlimited dogs) Make cheques payable to: Ontario DockDogs Sports Association ,767 Brock Rd. RR4 Flamborough, ON, L9H 5E4 -  info@ontariodockdogs.com