Pet Registration Form
I have read and agree to keep my pet in full compliance with all applicable Rules and Regulations and understand that non-compliance may result in a fine being charged to me. I further understand that, for sanitary reasons, I am responsible for the IMMEDIATE collection and proper disposal of all fecal matter deposited by my pet. I will notify the Association in the event of any change in this registration. NOTE: Wilkinsburg Code requires all dogs to have current rabies vaccinations and be licensed.
Type:
Name:
Color:
Breed:
Distinctive Markings:
Is this pet licenced?
Please Select
Yes
No
Not Applicable
Is this per vaccinated for rabies?
Please Select
Yes
No
Not Applicable
Owner Name:
First Name
Last Name
Owner Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Owner Phone Number:
Please enter a valid phone number.
Owner Email:
example@example.com
Owner Signature:
Date:
-
Month
-
Day
Year
Date
Print
Submit
Submit
Should be Empty: