Registration Request Form Loading… Course Registration Request 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:*WinterSpringSummerFallFor which course session are you requesting entry?Course you are requesting*Please choose:Puppy KindergartenPuppy ElementaryHome CompanionPerformance BasicsFoundation GamesBeginner NoviceNoviceOpenRally ConceptsUtilityRally All LevelsRally Advanced/ExcellentAgility PrepAgility 1Agility 2Agility 3Agility 4Advanced AgilityCompetition AgilityGraduate Open (Utility Concepts Prt 2)Intro to Scent WorkIntroduction to AKC TrackingOther class not listed (specify below)Day and Time (Please check current schedule for available days/times)*2nd preference of day/time if first choice not availableHave 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 FeesMembers: $40Non-member FeesNon-members: $60Dog'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:PhoneThis field is for validation purposes and should be left unchanged.