Registration Form Use the Short Course Registration Form to sign up for short courses. This for works best from a computer, sometimes it will not properly submit from a cellphone. Class Registration Email* Name* First Last Address Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Emergency Contact Name & Phone NumberWaiver form* Please click this link to read the DTCCU Waiver Form. It will open in a new tab or window. By checking this box, I agree that I have read, understand and accept the DTCCU Waiver form. Session*Please choose:Winter (Jan/Feb)Spring (Apr/May)Summer (June/July/Aug)Fall (Sept/Oct/Nov)Class desired*Please choose:Puppy KindergartenPuppy ElementaryHome CompanionSub-noviceBeginner NoviceNoviceNovice/OpenOpenOpen/UtilityUtilityRally FundamentalsAdvanced RallyBeg Novice/Rally ComboAgility PrepAgility 1Agility 2Agility 3Agility 4Advanced AgilityCompetition AgilityOther class not listed (specify below)Open and Utility ConceptsUtility ConceptsGraduate Open (Utility Concepts Prt 2)Obedience Drill TeamKIDZ N K9NZDay and Time*2nd Choice/Class not in listHave you been voted in as a DTCCU Member?*MemberNon-memberUsing Teacher Priority? (If you instructed or assisted a class during the previous session, you may use your teacher priority this session.)*NoYes, I will use teacher priorityMember FeesPlease choose:Members: Agility $50 per dogMembers: $30 for first course (other than agility)Members: $25 for any other course during same session (other than agility)Will be using class cardNon-member FeesPlease choose:$100 for first course with this dog$55 for subsequent session with same dog (other than agility)Agility: $75Fee paid yet?*NoYesDog's name*Dog's breed*Dog's sex*MaleFemaleIs Your Dog Spayed/Neutered?*YesNoDog's age*Previous training (with this dog) Have you: Owned a dog before Trained a dog before If you have trained a dog before, to what level? What do you like best about your dog? What do you want to achieve with this class? Distemper*Enter date of inoculation, MM/DD/YYYYParvo*Enter date of inoculation, MM/DD/YYYYRabies*Enter date of inoculation, MM/DD/YYYYVeterinarian's Name*Other comments or notes about your dog's health: CommentsThis field is for validation purposes and should be left unchanged.