Class-Agility Andy M Wednesday Class Payments

Agility Wednesday Class Payment Form

Must be already taking class or approved to join these classes
Starting Date of this session

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Time of your class

Hour Minutes

AM/PM Option
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Name of Dog
What, if any, agility classes or training have you taken with this dog?
If registering multiple dogs please add info below. Comments or Questions

Wednesday Agility Class Member TC Discount ONLY

$135.00 Quantity
Item subtotal:

Wednesday Agility Class SICDTC Member in Good Standing

$155.00 Quantity
Item subtotal:

Wednesday Agility Class Non-Member/Other Members

$225.00 Quantity
Item subtotal:

Help Us Pay Processing Fees

Optional: If you would like to help cover some of our processing fees please select. Thank you!

$4.00

Enter coupon

Total

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Agility Wednesday Class Payment Form