Rattlesnake Avoidance Clinic
Hosted by Four Winds Pheasant Club
 (310) 370-2238

Web Registration Form
(Please print, fill out and mail)
or
GO TO EMAIL REGISTRATION FORM

Advance payment of $50.00 per animal is required to reserve a date for the training. Please complete the registration form below and mail with your check or money order ($50.00 per animal)

payable to Sam Elder
Mailing Address
(Not Location of Club)
2806 May Avenue
Redondo Beach, CA   90278

Owner: ________________________________________________________________

 

Address: ______________________________________________________________

 

City: _______________________________State: ________Zip:_________________

Home Phone:_____________________Work Phone:__________________________

 

Pet’s Name                        Cost

_________________________________$50.00 per animal

 

_________________________________$50.00 per animal

 

_________________________________$50.00 per animal

 

_________________________________$50.00 per animal

Total Amount Enclosed___________________

Clinics Hosted by Four Winds Pheasant Club
 Please circle the date you wish to attend.
 

BY APPOINTMENT ONLY!

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© Copyright January 2, 1998
      (including background & photos)