Retriever Club Registration Form

Retriever Club Registration Form

Register yourself and your retriever for club membership. Please provide detailed information about yourself and your dog. All information is required for membership processing.
Owner Information

Please provide your personal details for club registration.
Owner's Full/Member's Name*

First NameLast Name
Name Additional Family Member

First NameLast Name
Name Additional Family Member

First NameLast Name
Email Address*
example@example.com
Phone Number*

Area CodePhone Number
Home Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Dog Information

Enter details about your retriever.
Dog's Pedigree Name*
Callname
Dog's Breed*
Dog's Age (in months!!)*
MaleFemale
Dog's Health Information (e.g., vaccinations, medical conditions)*
Upload Dog's Pedigree (if any)

Cancelof
Club Rules & Agreement

Please read and agree to the club's rules and regulations to complete your registration. You can find them on the website of the Retriever Club Luxembourg.
Membership Payment

Select your membership type and proceed with payment to complete your registration.
Membership Fees
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Name: A bis Z

Name: Z bis A

Preis: niedrig bis hoch

Preis: hoch bis niedrig

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Standard Membership
Annual membership for one adult.

€40.00 Quantity



Each Additional Family Membership
Annual membership for each family member

€5.00 Quantity



Standard Membership
Semi-annual membership for one adult.

€20.00 Quantity



Training fee
Annual training fee

€360.00 Quantity



Training fee
Semi-annual training fee

€180.00 Quantity



Membership Breeder
Annual membership for Retriever Breeders

€50.00 Quantity



Gesamt

€0.00
Bank transfer

Please transfer the corresponding amount to the following account:
LU19 0021 1211 1576 1900

(BILLLULL)
Signature
Should be Empty:

Retriever Club Registration Form

Owner Information

Dog Information

Club Rules & Agreement

Membership Payment

Bank transfer

LU19 0021 1211 1576 1900