141 Howley Ave.
Beaver Falls PA 15010
I (WE) the undersigned do agree to have MY (OUR) information from the
|WEBSITE BREEDER REFERRAL RELEASE FORM
If you would like to
have your name and
included on our BCKC
Referral and theSVC website you must be a
member in good
standing of BCKC. You
are REQUIRED to
complete and sign this
form and return it to
Your name will not be
included without a
signed release on file.
You can print this
release and mail it to
Phil at the address listed on the right.
PLEASE CIRCLE THE DIRECTORY IN WHICH YOU PREFER TO HAVE YOUR
INFORMATION PUBLISHED ON THEIR WEB SITE.
Circle both if you wish to be included in both directories.
|Website Information Release Waiver