Litter Registration
Type or write very clearly
Number of Puppies to Register_______________________Date Whelped_____________________________
Breed_____________________________________________________________________________________
Kennel Name_______________________________________________________________________________


Sire:______________________________________________________________________________________
Color:________________________________________Date of Birth_________________________________
Registration Number________________________________________________________________________
Owner of Sire:_________________________________Date of Service_______________________________

Dam:______________________________________________________________________________________
Color:_________________________________________Date of Birth________________________________
Registration Number________________________________________________________________________

Owners Name of Litter at Birth_______________________________________________________________
Address:___________________________________________________________________________________
City:______________________________________________________________________________________
State______________________________________________________Zip_____________________________
E-Mail_____________________________________________________________________________________
Phone_____________________________________________________________________________________

Print and complete form and enclose $8.00 Postal Money Order Registration to:
(Make money order payable to Ray Giacobbe)
Ray Giacobbe
1700 Ridgewood Avenue, Suite D
Holly HIll, Florida 32117