FOUR PAWS FUR FUN Club
Please print clearly

Annual Dues:
          ___   $35 Family Membership (2 adults and children under18)
          ___   $20 Individual Adult Membership
	  ___   $15 Individual Junior Membership

Name: ______________________________________________________

Address: _____________________________________________________

City: _________________________State: ___________Zip:___________

Home Phone: __________________ Work Phone: _____________________

E-Mail Address: _______________________________________________

How Many Dogs do you own? ______________
Dog Info.
Name: ____________________ Breed: ____________________ Age: _____

Name: ____________________ Breed: ____________________ Age: _____

Name: ____________________ Breed: ____________________ Age: _____

Waiver of Club Responsibility and Acknowledgement of Club Constitution and By-Laws
In Consideration of the acceptance of club membership in Four Paws Fur Fun, I agree to hold the club, it's members, directors, officers and agents harmless from any claim for loss or injury caused by and/or to myself and/or my dog's, however such injuries, death or damage to the property may be caused.

I hereby assume the sole responsibility for my actions and shall hold the club (and members thereof) harmless from any and all loss and expenses, including legal fees.

I further agree to abide by the Constitution and By-Laws of Four Paws Fur Fun


Signed:______________________________Date____________________

Parents or Guardian of Junior___________________________Date_______
Make chech payable to FOUR PAWS FUR FUN
Mail To: 10680 Ridge Rim Trl. SE, Port Orchard, WA 98367