K-9 Registration

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K-9 Registration 2022

First Name

Last Name

Work Phone

Email

Date of Birth

Agency

Agency Address

Cell Phone

K-9 Breed

K-9 Age

K-9 Name

City, State, Zip

Level of K-9 Training/Experience

Basic

Intermediate

Advanced

Are you an accredited NAPWDA Trainer?

No

Yes

Do you plan to attend the banquet?

No

Yes

If yes, how many will attend, including yourself?

Current NAPWDA Member?

No

Yes

If yes, which type?

Regular

Associate

No refunds within 60 days of workshop.

Questions: Brian Mowry | 301.928.6687

Mike Alexander | mpalx@aol.com

NOTE: If you decide to consume any alcoholic beverage during the workshop week, you do so at your own risk. If you do drink an alcoholic beverage, please do so in a responsible manner & don't drink and drive.

Do you plan to test for NAPWDA certification in any phase(s)?

No

Yes

WAIVER: I hereby relinquish the Ocean City Law Enforcement K-9 and Police Motorcycle Exposition, OC AdventureFest, Hillbilly Shore Productions LLC, The Hogs and Heroes Foundation, The Ocean City Police Department, The Wicomico County Sheriff's Department, NAPWADA and their assigns, affiliates, sponsors, organizers and participants in any injury, mental or physical, to me or my canine, to include damage to any agency, or departmental vehicles, or equipment that may result from attendance at this event/training conference. I furthermore accept full responsibility for any damage caused by me or my canine to any property, or person related to my attendance at the event/training conference to include the hotel accommodations and any training venue. Further, I certify/attest that my canine and I are in a physical condition necessary to participate in all events necessary for certification as required.

Your Signature

Type Name

Select a date

I am an active or retired member of law enforcement or I am an active member of the military.

Thanks for submitting!