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ENTRY FORM for MCWDC - Workshop - Lee Summit, MO
Name of owner:_____________________________________________________________________
Name of dog:_______________________________________________________________________
Reg#_______________________Microchip#___________________ DOB:_____________________
Address:______________________________________________________________________________
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
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Signature of owner Print name to follow
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Copyright © 2010 Suzan Shipp/MCWDC. All rights reserved. Revised: ALL PICTURES AND CONTENT ON THIS website ARE THE SOLE PROPERTY OF Suzan Shipp, webmaster and Mid Central Working Dobermans Club and may not be used or copied without express written permission from the owner/webmaster. Copyrighted 2010