IDTC Class Registration form

Fees are to be paid when registering for class. Please fill out the following form, and remit with payment to the appropriate registrar by the registration due date.

 

Name:___________________________________  Telephone:_____________________

 

Address:________________________________________________________________

_______________________________________________________________________ 

 

E-Mail Address_____________________________ Dog’s Name:___________________

 

Breed:___________________    Age:_______                             

 

Male/Female                      Spayed/Neutered    or   Intact

 

Membership Status  (circle one) Active   Inactive   Non-member

 

Obedience class(es) registering for:___________________________________________

Listed Instructor:________________________  Class Time:_______________________

 

Previous level of training or last class taken___________________________________

 

 

Agility and advanced obedience classes are for IDTC members ONLY. Dogs need to have passed the CGC test OR been evaluated and approved  for participation by the Training Director.

 

Agility class(es) registering for:______________________________________________

Listed instructor:________________________  Class Time:_______________________

 

Previous level of training, or last class taken:___________________________________

________________________________________________________________________

Please sign up separately for Obedience and agility as follows:

Advanced Obedience Registrar: Amanda Pough  132 Genung Circle  Ithaca, NY  14850

Beginner Obedience Registrar: Marian Szebenyi  176 Jackson Hollow Rd. Newfield, NY 14867

Agility Registrar:  Pepi Leids,  7021 Boot Jack Rd.  Bath, NY 14810

 

Please include a copy of your rabies vaccination certificate for each dog being registered as well as dates for last DHP-P given.

 

Fees: Active Members: $20 per class              Mini Classes:Active                  $15

          Inactive Members: $70 per class                                  Inactive                 $30

          Non-Members: $85 per class                                      Non-Members      $40