Membership Application USABC

Membership Application USABC

Fill out and submit payment to purchase a membership for USABC
Name of Applicant (1)*

First NameLast Name
Name of Family Applicant (2)

First NameLast Name
Phone Number*
Please enter a valid phone number.
Phone Number of Family Applicant
Please enter a valid phone number.
Email*
example@example.com
Email of Family Applicant
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Prior USABC Membership Number
Club Affiliation Name & Number
WAIVER OF LIABILITY

I understand that participation in events is at my own risk. I will not hold United States American Bulldog Club, Inc. or any individuals representing United States American Bulldog Club, Inc. responsible for damage that may occur to my person, property, or dog as a result of the participation in trials or other activities held by the organization.

I understand that the training of my dog for all United States American Bulldog Club, Inc. events is my responsibility and I will conduct my training responsibly and humanely and with the best interest of my dog in mind.

I understand that it is my responsibility to carry ample insurance to cover potential damages my dog may cause or incur at United States American Bulldog Club, Inc. events.

I understand that it is my responsibility to read the Bylaws of the organization and to abide by them.

I understand that I alone am responsible for my actions and the actions of my dogs and I agree to keep my dogs under control at all United States American Bulldog Club, Inc. events.

I have read and agree to the above Waiver of Liability.
Signature of Applicant*

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Signature of Family Applicant*

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Breeder/Mentor
If you are paying by check, send this signed and completed membership application for one full year membership dues. (Print via button next to submit) OR Pay via PayPal below.

Make checks/ Money Orders payable to:

Diane Donnelly - USABC Secretary

34 Inkberry Rd, Levittown, PA 19058-1124
FOR INTERNAL OFFICE USE ONLY

DATE RECEIVED: __________________

EXPIRATION DATE: _________________

MEMBERSHIP NO. ASSIGNED:________________________________

FAMILY MEMBERSHIP NO. ASSIGNED:__________________________
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