Waimakariri Dog Training Club New Member form

Waimakariri Dog Training Club Inc.

New Member Form
Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Mobile Number
NZKC Membership #
Membership Type *
Payment can be made to the club's bank account 03-1592-0107913-000 (Please use your surname and membership as the reference) or by cheque or cash payment.
In joining the club there is an expectation that members will volunteer their time and participation in the organisation and running of all events. *

Yes
Have you done any dog training before?
Waimak pre-agility

Yes No
Other pre-agility

Yes No
Other levels

Yes No
Currently competing

Yes No

Dog Details

Name

Breed

Age

Class

Dog 1

Dog 2

Dog 3

Dog 4

Waimakariri Dog Training Club Inc.