Mid-Central Working Dobermans Club
Member club of the United Doberman Club - to protect and preserve the working abilities of the Total Doberman Pinscher and to promote responsible dog ownership in the United States of America.

A working Doberman Club All American Mid Central Working Doberman Club

Workshop Entry Form

ENTRY FORM for MCWDC - Workshop - Lee Summit, MO

Name of owner:_____________________________________________________________________

Name of dog:_______________________________________________________________________
Reg#_______________________Microchip#___________________ DOB:_____________________

City:________________________________________________ State_______________ Zip______

E mail:________________________________________________Phone#____________________

Please check Classes to enter:

Workshop fees are as follows: Number of dog/s you will be working:
$100.00 per day for 1st dog
$80.00 per day for 2nd dog or 3rd dog (max)
$50.00 per day for puppies up to 12 months

Check if you have already signed and have on file in our office your Club waiver form._______________
Total Amt enclosed: $_________________________________

Authorized Agent/Owner Signature:___________________________________________________Date________________

You can complete on line by copy pasting this form into e mail and sending to mcwdclub@gmail.com and making payment through paypal - send money to mcwdclub@gmail.com (this is much easier and we prefer paypal) Make checks payable to: Mid Central Working Dobermans -
Mail to: 795 NE 101 Road - Warrensburg, MO 64093
660 441-3822

I have read the above and wish to enter my dog:

_____________________________________________________________________________s will close Aug 31st

Signature of owner Print name to follow

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