USMRA Decoy Certification Request - Hosted by Club
Date of Certification
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Month
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Year
Date Picker Icon
Club Hosting Decoy Certification
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Please Select
Independent - No Club Affiliation
Big Apple Mondioring
Bite-Club Mondio
Bite Co. Ringsports
Black Diamond Working Dog Club
Carolina Dog Sport Club
Castle Rock Ringers
Colorado Springs K9 Club
Desert Wolves Mondio
Esprit de Corps Mondioring
Evolution Working Dog Club
Fair Play Mondio
Fearless Ring Sport
Feisty Malinois Mondioring Club
Fire Pines Ring Club
Genesis Mondioring
Good Company Working Dog Club
Heartland Working Dog Club
Imperial Working Dog Club
Intégrité Working Dog Club
Junior Varsity Mondioring Club
Lone Star Mondioring Club
Marvel K9 Ringsport Club
Mile High Mondioring
Motley Crew Mondio Club
Ouray Working Dog Club
RedDirt Ringers
Rocky Mountain Guerrière
Rocky Mountain Ringsport
Rogue Ringsport
Santa Clarita Mondioring
SoCal Mondio
South Texas Syndicate Ringsport Club
Spirit of Competition
Steel City Working Dog Club
St. Louis Working Dog Club
Texas K9
Utah Protection Sports
West Penn Mondioring Club
Other- list*
Certification Field Address
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Contact Person
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First Name
Last Name
E-mail
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Phone Number
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Area Code
Phone Number
Preferred method of contact
Phone
Email
Facebook
USMRA web site can use the checked responses for USMRA Clubs web page :
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Contact person
E-mail
Mailing Address
Phone
Requested Selection Committee:
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Names of available dogs for certification. Dog Title. Handler Name. Handler Contact
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Club Insurance Info - If private individual/club policy, list Company, Policy number and Contact info. You MUST attach or send policy copy to the USMRA Secretary. If your club has no private insurance write "USMRA". You must submit a Request for Insurance Certificate. The link to the request can be found on the USMRA Website.
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By submitting this document, this club and it's members and agents agree to abide by USMRA by-laws, the USMRA Code of Conduct and policies and procedures. We also agree to notify USMRA Secretary in writing of any by-laws, membership or event changes, as well as event incidents and procedure deviations. USMRA is committed to an anti-discrimination policy in all of its programs. Membership entitles all members in good standing to attend all USMRA sanctioned events.
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Agree
Signature:
Date
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Year
Date
Copy of Private Club Insurance
Submit
Should be Empty: