New Membership Application

Blue Ridge Bernese Mountain Dog Club New Membership Application

New Members are required to sign up as an Associate Individual, Associate Family, or Junior Member for the first year (or partial year) of membership. Upon membership renewal for the following calendar year, applicant will be eligible for Regular Membership. The following membership dues apply:
A. ($15) Associate Individual (One Adult Member in Household)
B. ($25) Associate Family (Two or More Members in the Same Household)
C. ($15) Junior (10-17 years old)

Notes

Payments to BRBMDC for dues or support of its programs are not deductible for tax purposes.
Applications received after September 1 are prorated at 50% of dues for that calendar year.

* Indicates required field

Type of Membership *

A B C

Applicant 1 *

First

Last

Birth Month 1 *

Mobile Phone - 1 *

Email - 1 *

Occupation - 1 *

Home Phone *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Family Applicant 2 *

First

Last

Birth Month 2 *

Mobile Phone - 2 *

Email - 2 *

Occupation - 2 *

Please enter information for any additional family members: *

Dog Information

Are you a first time Bernese owner? *

Yes No

How many Bernese do you currently have? *

Kennel Name *

Dog 1 Registered Name *

Dog 1 Call Name *

Dog 1 Breeder *

Dog 1 Berner-Garde ID *

Dog 2 Registered Name *

Dog 2 Call Name *

Dog 2 Breeder *

Dog 2 Berner-Garde ID *

Please enter information for any additional dogs in comment box below. *

Sponsors - Two active members must sponsor membership application. By entering the contact information below, you certify that the named members have agreed to sponsor your membership.

Sponsor One Name *

First

Last

Sponsor One Email *

Sponsor One Phone *

Sponsor Two Name *

First

Last

Sponsor Two E-mail *

Sponsor Two Phone *

There are many opportunities throughout the year to assist with club activities. Some of these include assisting with tasks at draft tests, rescue support, planning and assisting with club events, communications and membership support. We appreciate all contributions of time and talent. Please list any areas in which you may be able to volunteer.

Volunteer Opportunities *

Bernese Mountain Dogs enjoy a variety of activities with their humans. Some are competitive events such as draft, confirmation, agility, rally, obedience, herding and barn hunts. Others prefer more social activities involving health and behavior, therapy work, and practicing good manners at friendly get-togethers. Please list any areas of interest (no experience necessary).

Owner/Dog Participation *

Dates of club meetings/events already attended:

Event/Date *

How did you hear about Blue Ridge Bernese Mountain Dog Club? *

I, the undersigned, (by clicking the SUBMIT button below) hereby apply for membership in the Blue Ridge Bernese Mountain Dog Club and hereby agree to abide by the constitution and bylaws of the club and by the rules and regulations of the American Kennel Club now and hereafter made.

Upon Clicking the submit button, you will be presented with membership dues payment options.

Date *

Submit