Membership

Submit Membership Information to:

Randy Kuntz

130 Stonehaven Drive, Waterloo, ON, N2L 6B2
 

Email : randeye@golden.net

New _____  Renewal _____

Family $20.00  Adult $16.00  Youth  $12.00

Last Name ________________________   First Name ________________________

Additional Name(s) for Family Membership __________________________________

Address ____________________________________________________________

City _____________________________  Province/State ______________________

Postal/Zip Code ____________________  Phone Number _____________________

Email Address ______________________ May we publish your contact info  Yes  No

Breeds Raised _______________________________________________________

Print off and submit to Randy. 

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