LDC Professional Pet Products          
Registration Form       Training Classess            Conformation

Faxed in or Drop off at the store

BREED   VARIETY (1) SEX
  Beginning Classe  $50.00 for 4 classes
  Intermediate Class

 check

if a JR
$50.00 for 4 classes

NAME OF HANDLER
_______________________________________________________________________________________


_______________________________________________________________________________________

DATE OF BIRTH( if a Jr Handler )
_______________________________________________________________________________________



(Please Print Legibly)

ACTUAL OWNER (S)

OWNER'S ADDRESS

CITY____________________________________STATE_________________ZIP______________________

NAME OF OWNER'S AGENT
(if any) AT THE SHOW_____________________________________________ID #_____________________

I CERTIFY that I am the actual owner fo the dog, or that I am the duty authorized agent of the acual owner whose name I have entered aboved by any additional ruless and regulations appearing in and further agree to be bound by the Agreement printed on the side of this entry form. I (we) certify and represent that the dog enterd is not a hazard to persns or other dogs. this entry is submitted for acceptace on the foregoing representaion and agreement.We will not hold LDC or any of their staff or judges repsonsible in case of injury of dealth.

SIGNATURE of Owner or his agent
duly authorized to make this entry______________________________________________________________

Telephone:_______________________________________________________________________________

                     
Credit Card # _______________________________exp______ We accept MC or Visa or American Express.

Paid by Cash _____________________________ Paid by check # ______________________

Fax to 262-549-7775

Mail to LDC Professional Pet Products
S52 W24082 Glendale Rd
Waukesha WI 53189

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