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Mornington Peninsula Community Dog Club Online Membership Form
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Indicates required field
Name
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First
Last
Email
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Phone Number
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Address
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Line 1
Line 2
City
State
Zip Code
Country
Postal Address (if different)
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Line 1
Line 2
City
State
Zip Code
Country
Membership Type being applied for
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Junior (Under 18)
Single
Family
Single Concession
Family Concession
Proof of concession (if applicable) must be provided at the time of enrollment
V.C.A. Membership Number (if applicable):Untitled
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The Victorian Canine Association Inc (VCA) is a non-VCA member insurance levy that is required to be collected and forwarded to the VCA by all affiliated clubs. This levy applies only to Victorian club members who are not members of the VCA Inc, if you are already a member of VCA let us know and we will adjust the Annual Fee accordingly.
Dogs Name
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DOG BREED.
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SEX OF DOG
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VACCINATION DUE
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Proof of full dog vaccination must be provided at the time of enrollment
By clicking below, you agree to abide by Mornington Peninsula Community Dog Club Rules
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I acknowledge at all times I shall be wholly and totally responsible for the care, well-being, health and actions of any dog under my charge at any Club Activity and I declare that the above information provided is true and correct at the time of submiting. By checking this box, I confirm I have read the Club Rules and agree to abide by these rules at all times.
I acknowledge at all times I shall be wholly and totally responsible for the care, well-being, health and actions of any dog under my charge at any Club Activity and I declare that the above information provided is true and correct at the time of signing. By signing below, I confirm I have read the Club Rules and agree to abide by these rules at all times.
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