Membership Registration Form Membership Form Use this form to register as a member of the Cambridge Dog Club. After you submit the form, you will be taken to our payment service to pay your fees. Membership Type*Please choose from the following memberships: Single Membership: (Full year) January to December $40.00 From: 1st June $25 Junior (Under 21) Membership: (Full year) January to December $20.00 From: 1st June $10 Senior (65 and over) Membership: (Full year) January to December $20.00 From: 1st June $10 Associate Membership: (Where an associate is in a 'legal' relationship ie marriage/defacto with a 'single' member but will not be training at the club) - (Full year) January to December $20.00 From: 1st June $10 SingleJuniorSeniorAssociateMember DetailsFull Name* Address* Street Address Address Line 2 City ZIP / Postal Code Email Home phoneWork PhoneMobile PhoneAgilityAgility TrainingAlso please select one if you are doing agility training: Agility - one term - $25 Agility - one year - $80 Obedience - one term - $30 Dog DetailsPlease add information on your dogs. You will need to show current registration tag and vaccination certificate at enrolment.Dog Details*Dog NameBreedAge Dog Registration*Is/are your dog(s) currently registered? Yes/No Yes, my dog/s is/are registered Vaccination*Is/are your dog(s) currently vaccinated? Yes/No Yes, my dog/s is/are vaccinated Please ReadPlease ensure you read and understand the following conditions of membership.I/we accept the club, or anyone acting officially on behalf of the club will not be held responsible for injury to my dog or myself while on the club grounds. I affirm that to the best of my knowledge, my dog is sound in body and fit to participate in obedience and/or agility. I understand that under the N.Z.K.C regulations my dog must be 18 months or over to be eligible to participate in any agility training on the club grounds (unless under direct instruction in the pre-agility class). I agree to abide by the rules of the club. I understand that as a club member I am expected to help at our club’s shows and working bees. Registration Year*Please select today's date CommentsThis field is for validation purposes and should be left unchanged.