You are registering for the following course:

Course name: SUSAN'S PREPPING FOR PRIME TIME CAMP IN FLORIDA
Date: Friday, February 5 - Sunday, February 7, 2010
Time: 9:00 am - 5:00 pm
Location: Palm Bay, Florida
Price: $655 CAD ($595 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 (*):
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 (*):   
Agility titles (if any):
Motivation level:High  Medium  Low
Jump height initial (USDAA - only necessary for full camps)
Jump height rest of camp (USDAA - only necessary for full camps)
Enter any other information or special requests that you would like to send to us:
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