CACDC Membership Application

Membership Application

To apply for membership please complete all questions.
Name

First NameLast Name
Name

First NameLast Name
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail
example@example.com
Home Number
Format: (000) 000-0000.
Cellular Number
Format: (000) 000-0000.
HerdingConformationScentworkObedience / RallyAgilityBreedingPet
Other interests:
If you are becoming a new member what are the names and phone numbers of of the two members sponsoring you. Don't know any members no problem, we are happy to reach out to you and help you with your membership application.
YESNO
YESNO
Please explain a yes answer to the above two questions
YES
YES
I authorize and consent to the released parties and those acting on their authority, the unrestricted right and permission to use, publish / republish any photographic or video images of me, my minor child, and or my dog for CACDC's promotional and marketing purposes. I also permit CACDC's use of any printed material in connection therewith and relinquish any right to review or restrict its use or publications, including website entries, without payment or any consideration. I understand and agree these materials will become the sole and exclusive property of CACDC.

YESNO
My Products
prevnext( X )
New Individual
$20.00 Quantity



Renewal Individual
$15.00 Quantity



New Family
$25.00 Quantity



Renewal Family
$20.00 Quantity



New Junior 16 and Under
$ Free Quantity



Renewal Junior 16 and Under
$ Free Quantity



Annual Trophy Donation
$5.00 Quantity



Annual Trophy Donation
$10.00 Quantity



Total

$0.00
I (we) have answered these statements honestly and I (we) certify that I (we) am (are) in good standing with the American Kennel Club. I (we) agree to abide by the rules and regulations of the American Kennel Club as well as the Constitution and Bylaws and policies of the Cascade Australian Cattle Dog Club (CACDC).
TRUE
IF A NEW MEMBER PLEASE LIST THE AKC REGISTERED NAMES AND NUMBERS OF YOUR AUSTRALIAN CATTLE DOG(S):
Signature
Signing Date

MonthDayYear
Date
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