Renewal Form

Membership Renewal

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Please complete this online form, pay $15.00 per person annual dues and attach a copy of your current national therapy dog registration card (NTD) by January 1st to maintain your active membership. Renewals will also be accepted at the annual membership meeting. Active members must have a registered therapy dog. Active members are entitled to one vote at membership meetings. Support members do not have any of the above requirements and are not entitled to vote. Junior members are under 18.

Contact Details

Membership type(Required)

Active

Junior

Support

NTD#(Required)

Expires(Required)

Name(Required)

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email(Required)

Phone

Can the above information be made available to other PFL members?(Required)

Yes

Dog Details

Dog's Name(Required)

Dog's Breed(Required)

Dog's Birthdate(Required)

Dog's Name

Dog's Breed

Dog's Birthdate

Dog's Name

Dog's Breed

Dog's Birthdate

Membership Statement

I agree to abide by guidelines adopted by Paws for Love when working my dog under the name of Paws for Love. I agree to notify Paws for Love of the facilities that I visit under the name of Paws for Love, including any changes to regularly scheduled visits. I understand that Paws for Love does NOT provide liability or any other form of insurance while participating in visits or other activities under the name of Paws for Love. I agree to hold Paws for Love harmless for any incidents that may occur while participating in therapy visits or other activities under the name of Paws for Love.

Name(Required)

First Last

Membership Statement Signature(Required)

Dog Health Statement

I agree to keep my dog(s) current on all required vaccinations and to perform an annual stool check to ensure that he/she/they is/are free from internal and external parasites.

Name(Required)

First Last

Health Statement Signaure(Required)

File

Max. file size: 50 MB.

Upload copy of NTD ID card

Annual Dues

Price:

Total

Payment Method

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Credit Card

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