EmailMe Form - 2026 Winter K9 Conference

Handler Information
Name *
First Last
Email *
Are you a registered USPCA Member? *
What is your primary region (12, 18, 21, etc.?) *
K9 Information
K9 Name *
Department Information
Department / Agency *
Invoice Email - (if invoice goes to different email)
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, 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 *
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