POODLE DAY™
CARMEL, CALIFORNIA
SEPTEMBER 29, 2012

Your Email:	Fields marked with an asterisk (*) are optional.
First Name:	Last Name:
City:	State/Province: Select State/Province Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland and Labrador North Carolina North Dakota Northwest Territories Nova Scotia Nunavut Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Yukon

1st Dog's Name:	Variety: Please select       Standard Miniature Toy Large Mix Small Mix	Type of mix: (1 dog: $20)
2nd Dog's Name:*	Variety:* Please select Standard Miniature Toy Large Mix Small Mix Other Family Dog	Type of mix:* (2 dogs: $30)
3rd Dog's Name:*	Variety:* Please select Standard Miniature Toy Large Mix Small Mix Other Family Dog	Type of mix:* (3 dogs: $40)
4th Dog's Name:*	Variety:* Please select Standard Miniature Toy Large Mix Small Mix Other Family Dog	Type of mix:* (4 dogs: $50)

Please continue only if you are going to pay for your registration in the next step.
You can only participate in the Poodle Day Parade after successful payment.
Please have your Credit Card or Paypal login info ready.