Download Instructions

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Payment Type:

Int./Date:

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Cowboy Capital Pet Assistance League
P.O. Box 2200, Bandera, Texas  78003
Phone: Connie Potter 830-510-6115/Marlene Heavner 830-510-6879

Name:

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Address:

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City:

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State:

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Zip:

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Dog's Name:

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M/F:

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Breed:

Age:

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Shots:

Rabies:

Parvo:

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Class:

BASIC:

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ADVANCED BASIC:

DATE CLASS STARTS:  April 4, 2004 TIME:  7:00 P.M.

I agree by signing this application that C.C.P.A.L. nor any of it's representatives, trainers, nor associates will be held responsible for any form of liability, theft, loss, death, or injury to any person or animal. I personally take full responsibility and liability for my dog, any personal belongings, and myself.  I agree to not to hold C.C.P.A.L. or any of its associates affiliated with C.C.P.A.L. liable while in or on the training facilities or any location associated with C.C.P.A.L.

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CCPAL REP:

Owner Sign:

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Date:

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Payment Amount:  $65.00

NO REFUNDS

* WE MUST HAVE 10 CONFIRMED REGISTRATIONS TO HOLD A CLASS*

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Phone #'s

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DHLP: