First Name*

Last Name*

Address

City

State/Province

Zip/Postal Code
 - 

Email*

Home Phone

Work Phone
x

Cell Phone

Alt Email

Text/Pager Email

How many basset hounds do you currently have? *

What is your dog's name*

How old is your dog?*

Is your basset able to walk for a mile with you?*

Has your basset had any behavior issues with other dogs or people? Please Explain*

Are your current pets spayed or neutered? If not, why?*

How many people will be participating?*