CGRC MEMBERSHIP APPLICATION © CGRC, 2001 Mail To: CGRC Membership   1033 Valley View Road   York, PA 17402

**********************************************************************

Instructions: Print or Download this file. Fill out the form below and mail to the above address. Please be sure to enclose your check made payable to CGRC, INC. Your check will not be cashed until you are voted into membership. Circle the correct answer and/or add addtional sheets of paper to respond to any question.
***********************************************************************

PLEASE PRINT
[ ] New Application [ ] Renewal Application

City: ____________________ State: _____ Zip: ___________-_______

E-Mail Address :______________________________

Type of Membership:

[ ] Family $20    [ ] Individual $15

[ ] Junior $5      Date; Of Birth  ____________(Jr's Only)

What are your interests?:

What would you like to do or learn about Golden Retrievers?:

What Knowledge or Experience could you share with other club members?:

Are you a member of any other Kennel or Specialty Club? [ ] Yes [ ] No
If yes, please specify (List All):

Are you a member in good standing of all clubs?: [ ] YES [ ] NO
(If NO, Please Explain)

Have you ever been suspended, or fined by the GRCA, AKC or any other club?: [ ] YES [ ] NO
(If YES, Please Explain)

Would you be willing to serve on Committee(s)?: [ ] YES [ ] NO

Participate in Club Activities and Events?: [ ] YES [ ] NO

CGRC would like to know about you and your dogs. Please answer the following questions, giving a short description about yourself and show history, if applicable.

Number of Dogs Owned and Breeds:

Dogs Names and Ages (Registered Name and Number if Applicable):

Are you a Breeder? [ ] YES [ ] NO      If YES, for how many years?: _______

Other Breeds:

Number of Litters Whelped to date: ________

BIOGRAPHICAL DESCRIPTION (Please give us a short description about you and your family and what you like to do. Add addtional paper if necessary):

***********************************************************************
Applicant(s) must be sponsored by 2 members of Chesapeake Golden Retriever Club in good standing. Submit this application with your check to the Membership Chairperson. You will be notified of membership approval at which time you will receive the Constitution & By-Laws and Membership Directory.

I(We) certify that the information supplied in this application is complete and correct. I(We) understand that any omission or misstatement herein can be grounds for rejection of this application or immediate termination of membership. If elected to membership, I(We) agree to abide by the Constitution and Bylaws, the rules and regulations of the American Kennel Club and/or The Golden Retriever Club of America. I(We) have read and understand the CGRC Code of Ethics and agree to abide by same as indicated by my/our signature(s) below.

(Upon receipt, application will be read at the next General Membership meeting and voted on, by the membership, at the following General Membership meeting.)

As a member, I will abide by the rules and documents of this Club, the Golden Retriever Club of America (GRCA), and the American Kennel Club (AKC). I will become familiar with the official AKC Golden Retriever breed standard , and I will do all possible to advance and protect those qualities.

I will be a responsible dog owner and provide a safe, healthy environment for all of my animals, ensuring they are not a public nuisance. Only humane methods will be used when training, exhibiting or working my dogs. UNDER NO CIRCUMSTANCES WILL I MISTREAT, ABUSE OR NEGLECT MY DOGS.

I will not keep Golden Retrievers for the purposes of sport fighting, attack training or solely for guarding or protection of property.

I will seriously consider not breeding dogs found to have any deleterious conditions likely to be hereditary in our breed. I will use only registered, pure bred Golden Retrievers for breeding.

Prior to being bred, the bitch and sire should be determined to be in good health, of appropriate age, conform to the AKC breed standard and have a good, sound temperament typical of the breed. When possible, they should be evaluated for genetic defects and hereditary disorders common to the breed, including radiographic evaluations for hip dysplasia by the Orthopedic Foundation for Animals (OFA) or PennHIP, ophthalmology examination by a board certified veterinary ophthalmologist with registration by the Canine Eye Registration Foundation (CERF), and an examination by a board certified veterinary cardiologist. Copies of testing results and certifications should be available to puppy buyers and the owners of the bitch or stud dog used.

If I sell a Golden Retriever all documents provided will be accurate and valid, including AKC registration certificates, purchase agreements and pertinent medical records or clearances.

I will not offer a dog of any age for the purpose of auction, raffle, lottery or similar function, no matter how worthy or charitable the cause. I will not sell to pet shops or act as a broker for dogs to be sold by another individual or organization.

Neither my membership status nor the Club's name will be used for personal gain or profit.

I will endeavor to demonstrate the highest degree of professionalism and to display standards of good conduct and principals of good sportsmanship. I understand that my personal conduct at our events and at other club's events, whether as a guest, exhibitor or spectator, and my personal care and treatment of dogs is a reflection of the Club.

____________________________
Witness Signature & Date

CGRCETHC.DOC 3/4/2001