Online Membership Application Form

BANKING DETAILS

Rainbow Hungarian Vizsla Club
First National Bank
Gezina Branch
Branch Code: 251545
Account Number: 62692836053
 
Please complete the online application form OR download and complete the membership application form. Email proof of payment (and scanned membership application form if you did not use the online application form) to [email protected].

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ONLINE MEMBERSHIP APPLICATION FORM
TitlePlease select one
Full Names
Surname
Additional Family Member #1
Additional Family Member #2
Home Address
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Telephone Number
Email Address

By applying for/renewing my/our membership with the Rainbow Hungarian Vizsla Club, I/we agree to:

  • Support the Constitution and By-Laws of the Club
  • Abide by the rules of KUSA and other sanctioning entities of Club events
  • Encourage high standards in breeding, training, and competing with Vizslas and
  • Promote the welfare of the Vizsla breed
KUSA Membership NumberIf Applicable
KUSA Registered Affix (Kennel Name)If Applicable

Name(s) of Vizslas owned:

Registered NamePet Name in Brackets
Date of BirthDate of Vizsla Birth
KUSA Registration NumberIf Applicable
Elbow & Hip ScoresIf Applicable
Registered NamePet Name in Brackets
Date of BirthDate of Vizsla Birth
KUSA Registration NumberIf Applicable
Elbow & Hip ScoresIf Applicable
Registered NamePet Name in Brackets
Date of BirthDate of Vizsla Birth
KUSA Registration NumberIf Applicable
Elbow & Hip ScoresIf Applicable
Registered NamePet Name in Brackets
Date of BirthDate of Vizsla Birth
KUSA Registration NumberIf Applicable
Elbow & Hip ScoresIf Applicable
Registered NamePet Name in Brackets
Date of BirthDate of Vizsla Birth
KUSA Registration NumberIf Applicable
Elbow & Hip ScoresIf Applicable
  • New members joining in the first 6 months of the year will pay full price and their membership will be renewable 1st of January of the next year.
  • New members joining between July and September will pay half price and their membership will be renewable 1st of January of the next year.
  • New members joining after 30 September will pay full price and will be deemed to have paid until the 31st of December the following year.
I am interested in:Check all that apply
Other Interest:Please Specify
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