Your Name (required)

Additional Handler Name (required)

Phone (Required)

Your Email (required)

Street Address (required)

City (Required)

State (Required)

Zip Code (Required)

Dog Name (Required)

Dog Date of Birth (Optional)

Dog Age (Required)

Dog Name 2 (Optional)

Dog 2 Date of Birth (Optional)

Dog #2 Age (Optional)

Dog Name (Optional)

Dog #3 Date of Birth (Optional)

Dog Age (Optional)

NEW YORK STATE LAW REQUIRES CURRENT RABIES CERTIFICATE FOR ALL DOGS

Please provide a copy along with your application.

I agree to adhere to the Bylaws of Hudson Valley DockDogs and will comply with the Rules and Policies of DockDogs Worldwide.