Additional Information

Before you continue we need to gather some additional information about you and your canine friend/s.

Additional Family Members

Add Family Members to Your MembershipYou can add up to three (3) family members to your account.

	First Name	Family Name
1
1

• Add Another Family Member

Details about Your Dogs

Dog DetailsEnter some information for each of your dogs.

	Dog Name	Dog Breed	Dog Age	Dog Sex	Desexed?	Fully Vaccinated? Remember to bring your dog(s)’ vaccination record when you come to the Club to complete your registration
1				Male Female	Yes No	Yes No
1				Male Female	Yes No	Yes No

• Add Another Dog

Emergency Contacts

Emergency Contact Details *Please enter the contact details for someone we can call in case of an emergency.

First Name	Family Name	Phone Number

Dogs NSW Membership Number

My Dogs NSW Membership NumberPlease note this is the handler / owners membership number NOT the dogs.