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)Scent WorkDay and Time (Please check current schedule for available days/times)*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: $30 for first course (other than agility)Members: $25 for additional course during same session (other than agility)Members: Agility $50 per dogWill 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: $75Dog's name*Dog's breed*Dog's sex*MaleFemaleIs Your Dog Spayed/Neutered?*YesNoDog's age*Previous training (with this dog, please list formal class taken, passed the CGC, etc.)* 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: NameThis field is for validation purposes and should be left unchanged.