EmailMeForm
2023 Region 12 PD1 Trial
Hosted by Chisago County Sheriff's Office
When: June 25-27, 2023
Contact: Chad Stenson
email: chad.stenson@chisagocountymn.gov
phone: 651-213-6363
Registration: $150
MUST BE UP TO DATE ON YEARLY MEMBERSHIP PRIOR TO PARTICIPATING IN THE CERTIFICATION.
HOST HOTEL:
AmeriVu Inn and Suites
Chisago City, MN
Phone: 651-213-3400
OVERFLOW HOTEL:
Holiday Inn Express - St. Croix Falls, WI
Phone: 715-483-5775
Handler Information
NAME (How you want your name listed on your certificate)
*
First
Last
PHONE (best contact # in case we need to contact you regarding your registration)
*
###
-
###
-
####
EMAIL
*
Are you a registered USPCA Member?
*
Yes
No
What is your primary region?
*
Please select
12
18
21
K9 Information
K9 Name
*
Department Information
Department / Agency
*
Phone
*
###
-
###
-
####
Address
*
Street Address
City
State / Province / Region
Postal / Zip Code
I hereby waive and relinquish the United States Police Canine Association, Inc. (USPCA), Region 12, The Chisago County Sheriff's Office, event organizers, event judges, stewards, other participating K9 teams, and any other 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 event 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.
I agree to the above statement
*
Yes
No
Total
$150.00
