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United States Police Canine Association Region 3
A Professional Law Enforecement Canine Training and Certifying Association

The United States Police Canine Association Region 3, Inc.

Date:

Location:

Registration:

Check In:

 

  *** ALL FIELDS ARE REQUIRED***
Name:
Address:
City: State: Zip Code
Telephone:
Email:
Department: Department City:
K9 Name: Need Plaque  

Typing in your name acts as your signature

Form Completion Date

I hereby waive and relinquish the United States Police Canine Association (USPCA) ‐ Region Three, Inc, the Prince William County Government, Kettle Sod Farm, event organizers and associations of this event from any physical or mental injury to either myself or my canine. I also agree to abide by the rules established by the USPCA while attending this event. I accept responsibility for any damage caused either by myself or my canine to the hotel or any related events sites and/or location. I furthermore accept any responsibility for any injury or damage caused by either my canine or myself to any other person or property while attending this event.

 
Make Checks Payable and mail to: USPCA Region Three
17213 Hoskinson Rd
Poolesville, MD 20837
Fax To: (888) 528‐6610

 

You must be a full time member of the USPCA to participate. Certificate of Certification issued to all qualifying teams.

     
 

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2002-2007 United States Police Canine Association, Inc. Region Three
633 Pennsylvania Ave SE #243 Washington, DC 20003
Fax: (888) 528-6610
Questions or Comments Please e-mail us: ceo@kubitt.com

 
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