ETRC Membership Application

Please fill out the following form, print it, and send with your $25 to our treasurer. When we receive your information, we will add it to our website if requested.  Annual renewal date: March 1.
 
Mail this form & dues to:

Chuck Atchley
1927 Kings Estate Rd
Sevierville, TN 37876
 
 
First name:
  
Last name:
  
 Spouse name:
  
Street address:
  
City:
  
State:
  
Zip Code:
  
Phone:
  
 Work Phone:
  

Cell Phone:

  
E-mail:
  
 
Dog Full Name & Titles Breed Age
     
     
     
     

 
Judging Experience?

 q Puppy    q Junior  q Senior   q Master
 
Please Check Primary Interests:
qAKC Hunting Tests
qField Trials 
qHunter's Safety Course Compl		 qDog Training 
qClub Trials 
qDucks Unlimited Member		 qNRA Member 
qJudging/Judging Clinics

I agree to abide by the by-laws of the East Tennessee Retriever Club, Inc. and the rules and regulations of the American Kennel Club. I acknowledge and agree that the membership in East Tennessee Retriever Club, participation in East Tennessee Retriever Club activities, and the use of East Tennessee Retriever Club provided facilities or grounds are a good and valuable consideration for the release of the East Tennessee Retriever Club and its members, officers, agents, servants, volunteers, employees, and the owners of the East Tennessee Retriever Club provided facilities or grounds from any liability arising therefrom.  Accordingly, i hereby acknowledge and agree, for myself, my heirs, executors, administrators, successors and assigns, to release and forever discharge the aforementioned from any and all claims, demands, liabilities, actions or causes of action and costs arising out of East Tennessee Retriever Club activities, actions or any of the aforementioned, and/or use of East Tennessee Retriever Club provided facilities or grounds.

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