2010 Health Clinic Registration Form
This form is for registering your dog(s) for the health clinics to be held at the 2010 AWC National Specialty.
Note that we can accept checks or PayPal as payment for the clinics (you can use your credit card via PayPal).
You will be given a choice on your method of payment after you have filled out the registration form.
Enter your information here then click the "Confirm" button for final review and payment.
My Information
First Name: 
Last Name: 
Address: 
City: 
State/Prov: 
Postal Code: 
Country: 
Phone: 
Email: 
Registration Information
CERF Testing:  # Dogs:  @ $30 each = $ 0
BAER Testing (use one line only)
BAER Testing - results released to WHF Database:  # Dogs:  @ $25 each = $ 0
BAER Testing - results remain confidential:  # Dogs:  @ $45 each = $ 0
Cardiac Echocardiogram exam (check one box only, limited to ONE dog per owner)
 Echocardiogram - results released to WHF Database: 1 Dog   @ $120 each = $ 0
 Echocardiogram - results remain confidential: 1 Dog   @ $170 each = $ 0
AKC DNA cheek swab test:  # Dogs:  @ $30 each = $ 0
Myostatin Deficiency DNA test (use one line only)
Myostatin Deficiency test - results released to WHF Database:  # Dogs:  @ $28 each = $ 0
Myostatin Deficiency test - results remain confidential:  # Dogs:  @ $48 each = $ 0
       
Total amount due:   $ 0
Click here to re-calculate if necessary
Additional Comments: 
You will get payment information after clicking on the "Final Review" button below.
  Please direct any questions or comments about this form to Mary Beth Arthur at marial@wi.rr.com.