You are registering for the following course:
Course name: FLATWORK SECRETS FOR HANDLING SUCCESS
Date: Thursday, April 8 - Friday, April 9, 2010
Time: 9:00 am - 5:00 pm
Location: Alberton, ON
Price: $435 CAD ($435 USD)
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YOUR INFORMATION (fields marked with an asterisk * are required)
First name (*):
Last name (*):
Address line 1 (*):
Address line 2:
City (*):
Province/State (*):
Province/State
===Canada===
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Nova Scotia
Ontario
Prince Edward Island
Quebec
Saskatchewan
Northwest Territories
Yukon
===United States===
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
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Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington D.C.
West Virginia
Wisconsin
Wyoming
OUTSIDE US AND CANADA
Postal/Zip Code (*):
Country (if outside US/Canada):
Telephone (*):
Email (*):
Retype your e-mail - must match above (*):
List previous camps and dates OR PRE-REQUISITES if applicable:
Date pre-requisite completed if applicable:
YOUR DOG'S INFORMATION (fields marked with an asterisk * are required)
Dog's name (*):
Dog's breed (*):
Dog's date of birth (*):
Month
January
February
March
April
May
June
July
August
September
October
November
December
Day
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
Agility titles (if any):
Motivation level:
High
Medium
Low
Jump height initial (USDAA - only necessary for full camps)
N/A
8 in
12 in
16 in
22 in
26 in
Jump height rest of camp (USDAA - only necessary for full camps)
N/A
8 in
12 in
16 in
22 in
26 in
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