The Canine Athlete & Competitor, Kingston, New York

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Registration Form

The Canine Athlete & Competitors

Dr. Tim Lewis & Dr. Kurt Illig
Saturday & Sunday • November 23-24, 2013
Accord • NY

First Name:
Last Name:
Business/Organization:
Address:
City:
State/Province:
Zip/Postal:
Work Phone:
Home Phone:
Email:
Method of Payment: Visa Mastercard Check in the Mail
Account Number
Expiration Date
Validation Code	Last 3 digits on signature panel.

*SEMINAR FEES*
*Saturday & Sunday • November 23-24, 2013*
	Saturday & Sunday Early Bird Until November 1	$139.00
	Saturday & Sunday with Lunch Early Bird Until November 1	$159.00
	Saturday Only Early Bird Until November 1	$75.00
	Saturday Only with Lunch Early Bird Until November 1	$85.00
	Sunday Only Early Bird Until November 1	$75.00
	Sunday Only with Lunch Early Bird Until November 1	$85.00
*Saturday & Sunday • November 23-24, 2013*
	Saturday & Sunday	$179.00
	Saturday & Sunday with Lunch	$199.00
	Saturday Only	$95.00
	Saturday Only with Lunch	$105.00
	Sunday Only	$95.00
	Sunday Only with Lunch	$105.00
*And don't forget...*
	Please send me more brochures to share with friends and colleagues.
	Notes/Special Requests:

An email confirmation will be sent to you for your files.

Please complete this registration form and mail in a check or provide us with your credit card number above. You can also phone or fax us your registration and payment information.
Please make checks payable to:

Petworkshops, LLC / Puppyworks
PO Box 938
New Paltz, NY 12561

email: events@puppyworks.com
phone: (917) 699-6440
fax: (845) 255-4920

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