Cape Cod Kennel Club
Basic Obedience Registration

Class Start Date: ________________

Your Name _____________________________________________________________

Address _______________________________________________________________

City, State Zip __________________________________________________________

Telephone _____________________________________________________________

Email _________________________________________________________________

Dog's Name ___________________________________________ Sex (M/F) _______

Breed ______________________________________ Date of Birth ______________

My goals: A Well-Behaved Family Pet __ Competition __

Other ________________________________________________________

Are there any issues with your dog that you would like to resolve:

I agree to abide by the rules of Cape Cod Kennel Club while attending or participating in training classes. I do not hold the Town of Barnstable, Cape Cod Kennel Club, its members, or trainers responsible for any loss or damage incurred by me or my dog, or by others to me or my dog. I acknowledge that the enclosed fee is non-refundable.

______________________________________________(______________)
Signature of Owner (Date)

SEND this completed form AND
- A copy of your dog's rabies vaccination record
- A copy of the adoption papers if claiming the one-time $5 rescue discount
- A check made payable to Cape Cod Kennel Club for $85 ($80 for club members), less the one-time $5 rescue discount if applicable

TO John Cappellina 1071 Main Street West Barnstable, MA 02668

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