Therapy Dog International Test Registration - Obedience Training Club of Palm Beach County

Please use this form to register for the Therapy Dog International Test. Online payment is required. You do not need a PayPal account to pay. Your registration for the test is not complete until your payment has successfully processed.

Register for TDI Test

Registration for TDI Test

Test date*
- June 1, 2022
Name*
First Last
Owner Name
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone*
Phone where you may be reached on day of test
Email*
Dog's Registered Name
Dog Call Name*
Dog's Breed*
Date of last Distemper/Parvo Vaccination or Titer*
Date Format: MM slash DD slash YYYY
Date of Last Rabies vaccination or titer*
Date Format: MM slash DD slash YYYY
Does your dog bark and lunge when on leash and around other dogs? Has your dog ever been in a fight resulting in injury to himself or others?*
- No
- Yes
Explain
Has your dog ever tried to bite another dog or person?*
- No
- Yes
Explain
PO Therapy Dog International Test
Price: $15.00
Option*
- June 1, 2022 6:00 pm
Total
$0.00
Hold Harmless True and Accurate and Signature*
I affirm that the information I have entered is correct, including information on my dog's behavior around other dogs. My dog's veterinary records will reflect the dates submitted above. In case of accident or injury to my dog or myself, including dog bites, I hold harmless Obedience Training Club of Palm Beach County (OTCPBC), its instructors, and its Board of Directors, from any claim or liability resulting from said accident or injury. I understand that animals, including my own dog(s), are unpredictable and that dog sports by nature are not without risk.
Are you ready to submit this form?*
All information is correct and complete. Online payment is required at time of registration. Failure of payment processing will void registration. I have my credit card or PayPal account information handy and am prepared to enter it now. Do not hit submit if you are not prepared to pay at this time.
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