Membership 2019

Stratford Dog Agility Membership Form
Name

First Name Last Name
E-mail
Phone Number

Area Code Phone Number

Address

Street Address
Street Address Line 2
City	State
Postcode	Country

By selecting this option, you agree to abide by the Rules and Regulations of Stratford Dog Agility. These rules and regulations can be found in the membership section of the website. *

I agree to abide by the Rules & Regulations of Stratford Dog Agility Inc.

Dog Information
Are you a Member of Dogs Victoria

Yes No
If Yes, please state your Dogs Victoria Membership Number.
Note: If you are not a Member, you will be required to purchase the $10 Non Dogs Victoria Insurance,
Your Dogs Name & Breed.

MEMBERSHIP

Membership covers you from the 1st January to 31st December of any given year. This joins you to the Club and DOES NOT include any training module.

Annual Membership $50.00

INSURANCE

You will have been asked if you are a Member of Dogs Victoria, if NO you MUST select the $10 Insurance option to cover you.

MODULES

Modules 1 to 3 are structured classes and run for 9 weeks with an instructor.

These modules are $45.00 each.

Module 4 or the OPEN class is for those who are already Trialling or are experienced handlers. This module has no formal instruction.

Module 4 runs for the year starting 1st Jan until 31st Dec at a cost of $50.00

AGAIN YOU MUST CHOOSE AT LEAST ONE OF THE ABOVE MODULES.
PLEASE SELECT OPTIONS REQUIRED BELOW.

Annual Membership $ 50.00 AUD

INSURANCE - Must choose if NOT a Dogs Victoria Member $ 10.00 AUD

Module 1 - Foundation $ 45.00 AUD

Module 2 - Basic Handling $ 45.00 AUD

Module 3 - Sequencing & Courses $ 45.00 AUD

Module 4/Open Class - Annual Fee $ 50.00 AUD

Total $ 0.00 AUD
PAYMENT by Bank Transfer (EFT) to:

Name: Stratford Dog Agility
BSB: 633 000
A/C: 156 033 086

Please use your name as a reference.
Should be Empty: