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.
Areas of interest
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.
Have you ever been suspended from the AKC or any other Dog Club
Have you at any time been associated with, or sold dogs to, a wholesale or retail canine operation?
Please explain a yes answer to the above two questions
I agree to have meeting notices and other club notices sent by email
I understand that meetings occur by Zoom, typically on the 3rd Tuesday of each month
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.
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).
Check this box to indicate the above statement to be 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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Membership Application

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