This form can be used to submit a new dog to the database or modify an existing entry. If you're updating an existing record, simply enter the information that has changed - the original record information will be kept unless it's over-ridden here.

PLEASE DO NOT SUBMIT A DOG UNTIL IT HAS BEEN OFFICIALLY REGISTERED. Enter as much of information as you can, but do not take any guesses - enter only what you know is accurate. Use the notes box for additional information that you would like to include.

If you have any comments or suggestions regarding this form, please by e-mail.

Contact Information
Your First and Last Names:	*
Your e-Mail Address:	*
Your Relationship to THIS Dog:	Owner Breeder Breeder and Owner Other *
Dog's Information
Photo of Dog:
Dog's Prefix Title(s):
Dog's Registered Name (no Titles):	*
Dog's Suffix Title(s):
Sire's Registered Name (no Titles):	*
Dam's Registered Name (no Titles):	*
Pet Name:
Sex:	Male Female *
Status:	Entire / Intact Neutered / Spade
Breed:	Chesapeake Bay Retriever
Color:	Brown (Light) Brown (Medium) Brown (Dark) Red-Brown Deadgrass (Light) Deadgrass (Medium) Deadgrass (Dark) Sedge (Red Gold) Tanpoint
Birth Date (yyyy/mm/dd):	//
Date of Death (yyyy/mm/dd):	//
Primary Registration Agency:	AKC - American Kennel Club (United States) CKC - Canadian Kennel Club (Canada) DKK - Dansk Kennel Klub (Denmark) DRC - Deutscher Retriever Club (Germany) KC - Kennel Club (England/United Kingdom) NHSB - Nederlands Honden Stam Boek (Netherland) NZKC - New Zealand Kennel Club (New Zealand) SKG - Schweizerische Kynologische Gesellschaft (Switzerland) SKK - Swedish Kennel Club (Sweden) UKC - United Kennel Club (United States)
Primary Registration Number:
Alternate Registration Agency:	AKC - American Kennel Club (United States) CKC - Canadian Kennel Club (Canada) DKK - Dansk Kennel Klub (Denmark) DRC - Deutscher Retriever Club (Germany) KC - Kennel Club (England/United Kingdom) NHSB - Nederlands Honden Stam Boek (Netherland) NZKC - New Zealand Kennel Club (New Zealand) SKG - Schweizerische Kynologische Gesellschaft (Switzerland) SKK - Swedish Kennel Club (Sweden) UKC - United Kennel Club (United States)
Alternate Registration Number:
Stud Book Number (mm-yyyy):
Microchip Number:
Tattoo Number:
Tattoo Location:
OFA Number:
CERF Number:
Hip Score:
Elbow Score:
DNA Profile:
Vaccines:	Yearly Every 3 Years Regular Rabies Only Puppy Shots Only Puppy Shots + Titers & Vaccs as Needed Single Puppy Shot Never Vaccinated Other
Diet:	Kibble / Pellets Home Cooked Raw - Billinghust (Veggies and Dairy) Raw - Prey Model (No Veggies or Dairy) Raw - Dehydrated Other
Notes:	These notes are saved in the dog's record and may be re-edited in the future.
Breeder #1:
Breeder #2:
Breeder #3:
Owner #1:
Owner #2:
Owner #3:

Recognized Titles
Prefix Titles	Suffix Titles
AFC - Amateur Field Champion CH - Champion CT - Champion Tracker DC - Dual Champ (CH & FC) FC - Field Champion (Field Trial/Lure Coursing) HC - Herding Champion MACH - Master Agility Champion NAFC - National Amateur Field Champion NFC - National Field Champion OTCH - Obedience Trial Champion TC - Triple Champ (CH, FC & OTCH)	AJP - Excellent Jumpers With Weaves "A" Preferred AX - Agility Excellent AXJ - Excellent Jumpers With Weaves AXP - Agility Excellent "A" Preferred CD - Companion Dog CDX - Companion Dog Excellent CNMH - Canadian National Master Hunter HI - Herding Intermediate HS - Herding Started HT - Herding Tested HX - Herding Excellent JC - Junior Courser JE - Junior Earthdog JH - Junior Hunter MC - Master Courser ME - Master Earthdog MH - Master Hunter MJP - Master Excellent Jumpers With Weaves "B" Preferred MX - Master Agility MXJ - Master Excellent Jumpers With Weaves MXP - Master Agility Excellent "B" Preferred NA - Novice Agility NAJ - Novice Jumpers With Weaves NAP - Novice Agility Preferred NJP - Novice Jumpers With Weaves Preferred OA - Open Agility OAJ - Open Jumpers With Weaves OAP - Open Agility Preferred OJP - Open Jumpers With Weaves Preferred PT - Pre-Trial Tested SC - Senior Courser SE - Senior Earthdog SH - Senior Hunter TD - Tracking Dog TDX - Tracking Dog Excellent UD - Utility Dog UDX - Utility Dog Excellent VST - Variable Surface Tracker