Membership Application

Select your membership type then enter your details:
Single - $20.00
Double - $30.00
Family - $40.00
Current member (this calendar year) only booking a class/classes

Name*:

Postal Address*:

Suburb*:

State:

Post Code*:

Mobile Phone:

Other Phone:

Primary Email*:

Confirm your Email Address*:

How many dogs do you want to enrol?*

First Dog:

Dog's Name*:

Breed*:

Gender*:

Date of Birth:

*My dog has current vaccinations.

Usual Handler:

First course for this dog*:

Second course for this dog:

Second Dog:

Dog's Name*:

Breed*:

Gender*:

Date of Birth:

*My dog has current vaccinations.

Usual Handler:

First course for this dog*:

Second course for this dog:

Third Dog:

Dog's Name*:

Breed*:

Gender*:

Date of Birth:

*My dog has current vaccinations.

Usual Handler:

First course for this dog*:

Second course for this dog:

Fourth Dog:

Dog's Name*:

Breed*:

Gender*:

Date of Birth:

*My dog has current vaccinations.

Usual Handler:

First course for this dog*:

Second course for this dog:

I agree to accept responsibility for all actions of my dog(s) whilst attending any event conducted by the members of Fred's Pass Positive Dog Training Club Inc. I understand that the Fred's Pass Positive Dog Training Club Inc or any of its officials do not accept any responsibility for any injury that is occasioned to any member of my family or my dog(s) and agree to indemnify them against any action at law. I agree to ensure that my dog(s) will be maintained under control, that they are immunised and will maintain immunisation whilst attending club activities. I further agree to abide by the Rules and Constitution of the club.

Juniors: All juniors (under 18 years) are required to have a responsible adult with them whilst on the grounds training.

Membership fee:

Class fee:

Total fee:

The dogs Vaccination Certificate/s must be brought with you to the intake night

Fred's Pass Positive Dog Training Club Inc
PO Box 167
Palmerston NT 0831
ABN 69 756 993 384

Have you played with your dog today?