Online Registration Form

All Breed Fun Match Pre-Registration Form

Please fill in the form completely and make your check out to CTC and mail to:

Lynne Ward

812 Sussex Court

Virginia Beach, VA 23464

Phone: 757-233-9071

You will not be confirmed until we receive payment.

Breed:

Variety:

Sex: Male Female

Dog Show Class:

Class Division:

Additional Classes:

Jr. Showmanship Class:

Name of Jr. Handler:

Jr. Hand. Age:

Full Name of Dog:

Date of Birth:

Name of Dog's Owner & Address:

Street Address:

Address (cont.):

City:

State:

Zip:

E-mail:

I accept full responsibility for participation in this fun match. The Colonial Terrier Club and Merrimac Dog Training Center is not responsible for any injury to participants, by-standers, dogs, or equipment damage that may occur during the match.

*Breed:*
*Variety:*
*Sex:*	*Male* *Female*
*Dog Show Class:*
*Class Division:*
*Additional Classes:*
*Jr. Showmanship Class:*
*Name of Jr. Handler:*
*Jr. Hand. Age:*
*Full Name of Dog:*
*Date of Birth:*
*Name of Dog's Owner & Address:*
*Street Address:*
*Address (cont.):*
*City:*
*State:*
*Zip:*
*E-mail:*