Application for Litter Registration PENDING NO

The Kennel Club General code of ethics

All breeders who register their puppies, and new owners who register ownership of their dogs with The Kennel Club, accept the jurisdiction of The Kennel Club and undertake to abide by its general code of ethics. Form 1 BREEDERS/OWNERS:

1. Will properly house, feed, water and exercise 9. Will clean up after their dogs in public places or all dogs under their care and arrange for anywhere their dogs are being exhibited. Application for appropriate veterinary attention if and when required. 10. Will only sell dogs where there is a reasonable expectation of a happy and healthy life and will 2. Will agree without reservation that any help with the rehoming of a dog if the initial litter registration veterinary surgeon who performs an operation circumstances change. on any of their dogs which alters the natural conformation of the animal, or who carries out 11. Will supply written details of all dietary a caesarean section on a bitch, may report requirements and give guidance concerning such operations to The Kennel Club. responsible ownership when placing dogs in a new home. 3. Will agree that no healthy puppy will be culled. Puppies which may not conform to the breed 12. Will ensure that all relevant Kennel Club standard should be placed in suitable homes. documents are provided to the new owner when selling or transferring a dog, and will 4. Will abide by all aspects of the Animal agree, in writing, to forward any relevant Welfare Act. documents at the earliest opportunity, if not immediately available. 5. Will not create demand for, nor supply, puppies that have been docked illegally. 13. Will not sell any dog to commercial dog wholesalers, retail pet dealers or directly or 6. Will agree not to breed from a dog or bitch indirectly allow dogs to be given as a prize which could be in any way harmful to the dog or donation in a competition of any kind. or to the breed. Will not sell by sale or auction Kennel Club registration certificates as stand alone items 7. Will not allow any of their dogs to roam at large or to cause a nuisance to neighbours or those (not accompanying a dog). carrying out official duties. 14. Will not knowingly misrepresent the characteristics of the breed nor falsely 8. Will ensure that their dogs wear properly tagged collars and will be kept leashed or advertise dogs nor mislead any person under effective control when away from home. regarding the health or quality of a dog.

Breach of these provisions may result in expulsion from Club membership and/or disciplinary action by The Kennel Club and/or reporting to the relevant authorities for legal action, as appropriate.

The Kennel Club, Kennel Club House, Gatehouse Way, Aylesbury, HP19 8DB Telephone 01296 318540 • thekennelclub.org.uk

The Kennel Club Limited Incorporated in England and Wales Registered No: 8217778 Clarges Street, London, W1J 8AB VAT No: 239096833

KC/102/06/20 All information is correct at time of printing Thank you for completing the application to register your litter with The Kennel Club.

Why register your litter online? Checklist:

The easiest and quickest way to register your litter is online through your Kennel Club account. If you would like to register your litter via this printed form, here is a check list to make sure we Registering online is also the only way you can purchase a space to advertise your litter on our have all the information we need to process your application. Find a Puppy service.

Our Find a Puppy adverts receive around 500,000 visitors every month from potential new puppy owners. The fee starts at £20 for non-assured breeders* and your advert will be displayed Have you completed all sections required? on The Kennel Club website for two months.

The Find a Puppy service offers: Have you checked any breed-specific rules for your litter?

• Individual photos of the puppies • Indicate if puppies will come with and parents insurance (optional) Have you checked that the dam and sire are in the correct registered ownership? • Allows you to select the whole litter or only • Display your breeder licence the individual puppies you wish to advertise details (optional) Have you checked all parties have signed the relevant boxes? • Display the price per puppy (optional) • Mark individual puppies, or the whole litter as sold • Highlight that parents have been health tested Have you ordered your pedigrees?*

To register online and advertise your litter, please visit thekennelclub.org.uk.

Have you included the correct payment? *Additional wording charged at an additional £5 for non–assured breeders and non-vulnerable breeds. (Certified Assured Breeders and vulnerable breeds receive this service free of charge). Members of The Kennel Club Assured Breeder scheme will no longer be automatically opted in for the Find a Puppy service. Have you activated The Kennel Club 5 weeks free cover for each puppy?

*Please note that pedigrees are sent separately. Enrol for Breeder Rewards today!

50,000 Breeders have trusted us to protect their puppies* What happens next? 1. Once your litter is registered you will receive a form (Form 6) to change The Kennel Club Awarded Best Claims Service two years running registered ownership for each individual puppy. Sign the reverse of this form and pass to 97% of claims paid† direct to the vet if the new owner prefers the new owner to enable them to change The Kennel Club registered ownership. Plus receive £10 for each free policy that continues on to a full policy 2. If you have an online account with The Kennel Club, please let us know who the new Immediate cover for injury and illness owner(s) are by visiting the ‘manage dogs’ section of your account and selecting the relevant puppy. Under the ownership section, you will be able to tell us the collection date, To activate cover visit name(s) of the new owner(s) and their email address. We will then contact them to guide them through the change of ownership process and provide them with further advice and kcinsurance.co.uk/breeder support once they bring their new puppy home. or call 03330 30 50 30 3. Activate the free cover for each puppy you sell - cover can be activated up to 7 days before

^Based on Agria Pet Insurance administrators of Kennel Club Pet Insurance being awarded Best Claims Service by Moneyfacts Consumer Awards 2018 the puppy is collected by the new owner. and 2019. †Based on 2019 claims data. *Based on the number of breeders who have activated Kennel Club Pet Insurance policies in the UK. The Kennel Club is an Appointed Representative of Agria Pet Insurance Limited, which is authorised and regulated by the Financial Conduct Authority. Financial Services Register Number 496160. Agria Pet Insurance Limited is registered and incorporated in England and Wales with registered number 4258783. Registered office: First Floor, Blue Leanie, Walton Street, Aylesbury, Buckinghamshire, HP21 7QW Form 1 Thank you for applying to register your litter onto Completing the litter registration process is easy The Kennel Club Breed Register. By doing so you will be helping to safeguard your puppies’ futures. Online Visit thekennelclub.org.uk/registrations Application for We kindly urge you to complete this form as early as possible to ensure all the relevant registration documents are available Post Complete and return the litter application form litter registration for the new owners at the time of sale/collection. (see section 14) This form should be used by the breeder to register, by name, all puppies in a litter under 12 months of age (see note*).

A guide to help you complete It is important to check for breed specific information on any Section 11 Additional items & fees Endorsements breeding restrictions and the colours available for your breed, Details of all registrations are published quarterly in The Kennel The breeder whilst the dog is still in their physical ownership can visit thekennelclub.org.uk/breeds-a-to-z add the following endorsements on the record of a puppy: the litter registration form Club Breed Records Supplement. If ordered, we will send you the Please note: The term UK address includes Northern Ireland. This does not expand to include the Republic of Ireland and the edition that includes the details of this litter registration. R Progeny not eligible for registration Section 1 Applicant and additional owners Channel Islands, or bitches also registered with the Irish Kennel Please note delivery may take up to four months. X Not eligible for the issue of an export pedigree All registered owners of the dam at the date of birth of the litter Club (IKC), the Guernsey Kennel Club (GKC) or The Kennel Club of should include their name on this application and all owners will Jersey (KCJ) who are still resident within these clubs’ jurisdictions. Section 12 Puppies be recorded and printed on any publications and documents These should be placed next to the relevant puppy the breeder Guidelines to naming puppies (please read carefully) relating to the dog. The applicant is the person who is applying Section 6 Kennel name wishes to be endorsed. for the registration either as the sole breeder or in partnership Breeders who have a Kennel Name should enter it in this box. • A name must consist of more than one word but not exceed Breeders wishing to endorse any puppies should make themselves 24 letters (including kennel name) with additional owners. The address stipulated on this application The dam must be in the identical ownership to that of the Kennel aware of the complete regulation contained in should be the address where the puppies were born and, as such, Name holder. • A name which conflicts with an active kennel name granted to The Kennel Club Year Book, including the need to obtain written any documentation will be sent directly to this address. another person will not be accepted and signed confirmation that the prospective new owner is aware In the case of joint ownership, you, as the applicant of this litter Section 7 The sire owner(s) name and address • A registered name cannot be repeated within a breed of the endorsement(s). application will act as the point of contact in regard to matters The sire owner(s) is the registered owner(s) of the sire at the date • The surname of the applicant is not acceptable pertaining to The Kennel Club. of mating of the litter. The declaration must be signed by all the Pedigrees • A word cannot be repeated when naming puppies However, any additional owners will also be able view the puppies’ registered parties. It is advisable to have this confirmation signed Please indicate which pedigree you require next to each puppy. information if they sign up for an online account. Please note, in at the time of mating. • If a kennel name is to be used when registering a litter, the the case of joint ownership, any other joint owners of the dam kennel name must appear as the first word in the name Five Generation Enhanced Pedigree - printed with £23 must include their title, first name/initials, surname and unique Section 8 Registered name and number of sire of litter • Numbers in figures and initials are not acceptable. Champions in red on A3 embossed paper email address in the additional owner section. The declaration If the sire is registered with an overseas kennel club, and resident Abbreviations may be disallowed Three Generation Pedigree - includes registration £10 must be signed by all registered owners of the dam. of the same country, in order for the sire to be recorded, the • Canine terms are not permissible e.g. ‘dog’, ‘bitch’, ‘kennel’, numbers and colours application must be accompanied with a copy of either the It is important that you check the current legislation as required by ‘Champion’, ‘Crufts’ and specific names of breeds Five Generation Pedigree £10 Three or Five Generation Pedigree (which cost £20 and £25 law, in relation to dog breeding licences. • The Kennel Club reserves the right to refuse any name, respectively) issued by the overseas kennel club confirming the Visit thekennelclub.org.uk/breeding-licence which it considers inappropriate or offensive. The Kennel registered ownership of the sire. Club retains the right to request a fresh name for any puppy Section 13 Methods of payment Section 2 Registered name and number of dam of litter Please note: If the sire has previously been issued with an after the registration has been accepted, in the event of a Please complete this section with your payment details authority to compete number, the above requirement does not An application to register a litter will not be accepted when: complaint being lodged with The Kennel Club which is upheld and return the application to: apply. Please write this number in section 5 in place of The Kennel Regulation B22 Club registration number. Puppy naming service The Kennel Club, 1. The dam has already whelped four litters save in exceptional Kennel Club House, circumstances and only provided the application is made prior Section 9 Litters produced by Artificial Insemination For an additional £20, The Kennel Club will create unique names Gatehouse Way, to the mating and with veterinary evidence as to the suitability for your puppies. This service is free for kennel name holders If your litter was produced by artificial insemination (AI), the litter Aylesbury of the bitch involved in the proposed whelping and permission using their own kennel name. application form must be accompanied by a completed Form HP19 8DB has been received, or 2 - The Kennel Club application for the registration of puppies If you have any queries regarding your litter registration 2. The dam has already reached the age of 8 years at the date of produced by artificial insemination (AI). Please note: Any objection to a name registered using this service whelping save in exceptional circumstances and only provided must be made in writing within one month of the registration please call us on 01296 318540. application is made prior to the mating, and the proposed dam Section 10 Caesarean Sections date. The Kennel Club has no obligation to change a name has previously whelped at least one other registered litter and The Kennel Club will not register a further litter if the dam has they have selected when requested, where all reasonable and permission has been received. Any such application must be already had two litters delivered by caesarean section, save relevant attempts has been made to carefully select a suitable supported by veterinary evidence as to the suitability of the for scientifically proven welfare reasons and this only normally name. We reserve the right to exclude the use of The Kennel bitch involved in the proposed whelping, or provided the application is made prior to the mating. Club’s designated kennel name being applied to the name of any individual puppy or entire litter if appropriate. 3. The dam was under one year old at the time of mating, or Emergency caesarean 4. The offspring are the result of any mating between father An operation which is performed under veterinary advice and Colours and daughter, mother and son or brother and sister, save in which is considered necessary in the best interests of the health The Kennel Club will no longer accept the registration of a puppy exceptional circumstances or for scientifically proven welfare and welfare of the bitch and puppies. reasons and permission has been received, or whereby the colour is denoted as colour not recognised. Prior to Elective caesarean submitting your litter application, please visit our website for more 5. The dam has already had two litters delivered by caesarean information on accepted and non-breed standard colours. section, save for scientifically proven welfare reasons and this An operation which is performed upon a request from the owner only provided the application is made prior to the mating. of a bitch. Provided that The Kennel Club reserves the right to refuse any application made under Regulation B22c.(1), (2), (4) and (5).

NOTES: The Kennel Club reserves the right to reject any application to for research (statistical purposes) and shared with trusted and reputable When submitted, this form remains the property of The Kennel Club. * The Kennel Club may consider an application for the late registration of register a kennel name or transfer any dog or to change or cancel or partners for the sole purpose of undertaking research to improve dog health dogs over the age of 12 months, or if adding a puppy to an existing litter suspend any registration and may cancel or suspend any registration or and welfare. The full Kennel Club rules and regulations are contained in The Kennel Club already registered. The application must be accompanied by a letter of transfer or grant of a kennel name already made. Year Book. explanation and is subject to a fee of £60 per dog. In the event that a breeder is required by law to obtain a breeding licence, The data and health screening results connected to your dog will be that breeder may be required to produce his/her licence to The Kennel Club. Check breed-specific information on any breeding restrictions at The acceptance of a registration is not a guarantee of its accuracy. published and used for registration and publication in relevant Kennel Club If such licence is not produced and / or no reasonable explanation is given, thekennelclub.org.uk/breeds-a-to-z documentation as well as included in The Kennel Club’s health test result any applications to register litters may be refused. To view details on The Kennel Club privacy policy please visit finder and inbreeding co-efficient calculator. The data may also be used thekennelclub.org.uk Form 1 Thank you for applying to register your litter onto Completing the litter registration process is easy The Kennel Club Breed Register. By doing so you will be helping to safeguard your puppies’ futures. Online Visit thekennelclub.org.uk/registrations Application for We kindly urge you to complete this form as early as possible to ensure all the relevant registration documents are available Post Complete and return the litter application form litter registration for the new owners at the time of sale/collection. (see section 14) This form should be used by the breeder to register, by name, all puppies in a litter under 12 months of age (see note*).

NOTES: The Kennel Club reserves the right to reject any application to for research (statistical purposes) and shared with trusted and reputable When submitted, this form remains the property of The Kennel Club. * The Kennel Club may consider an application for the late registration of register a kennel name or transfer any dog or to change or cancel or partners for the sole purpose of undertaking research to improve dog health dogs over the age of 12 months, or if adding a puppy to an existing litter suspend any registration and may cancel or suspend any registration or and welfare. The full Kennel Club rules and regulations are contained in The Kennel Club already registered. The application must be accompanied by a letter of transfer or grant of a kennel name already made. Year Book. explanation and is subject to a fee of £60 per dog. In the event that a breeder is required by law to obtain a breeding licence, The data and health screening results connected to your dog will be that breeder may be required to produce his/her licence to The Kennel Club. Check breed-specific information on any breeding restrictions at The acceptance of a registration is not a guarantee of its accuracy. published and used for registration and publication in relevant Kennel Club If such licence is not produced and / or no reasonable explanation is given, thekennelclub.org.uk/breeds-a-to-z documentation as well as included in The Kennel Club’s health test result any applications to register litters may be refused. To view details on The Kennel Club privacy policy please visit finder and inbreeding co-efficient calculator. The data may also be used thekennelclub.org.uk FOR OFFICE USE ONLY Form 1 REGRISTRATION NO. Register your litter quickly and efficiently online at thekennelclub.org.uk/registrations

Application for litter registration PENDING NO. Please refer to notes overleaf when completing the application. 12 PUPPIES Puppy names (see section 13) - A name must consist of more than one word and a maximum of 24 letters

PUPPY DOG BITCH COLOUR ENDORSEMENTS R X PREFERRED NAME Enhanced Pedigree £23 Your privacy is very important and we retain your data in accordance with our privacy notice which can be found on The Kennel Club website thekennelclub.org.uk 1 ALTERNATIVE NAME 5 Generation Pedigree £10 1 BREEDER(S) NAME & ADDRESS MICROCHIP NO. 3 Generation Pedigree £10 TITLE FIRST NAME / INITIALS LAST NAME

ADDRESS PUPPY DOG BITCH COLOUR ENDORSEMENTS R X POST CODE PREFERRED NAME Enhanced Pedigree £23 TELEPHONE No. Breeding licence? Yes No If yes, please provide a copy 2 ALTERNATIVE NAME 5 Generation Pedigree £10 EMAIL ADDRESS MICROCHIP NO. 3 Generation Pedigree £10 ADDITIONAL OWNERS - PLEASE LIST ANY OTHER OWNERS OF THE DAM AT THE DATE OF BIRTH OF THE PUPPIES

TITLE FIRST NAME / INITIALS LAST NAME EMAIL (OPTIONAL) PUPPY DOG BITCH COLOUR ENDORSEMENTS R X

TITLE FIRST NAME / INITIALS LAST NAME EMAIL (OPTIONAL) PREFERRED NAME Enhanced Pedigree £23 TITLE FIRST NAME / INITIALS LAST NAME EMAIL (OPTIONAL) 3 ALTERNATIVE NAME 5 Generation Pedigree £10 DECLARATION TO BE SIGNED BY BREEDER(S) MICROCHIP NO. 3 Generation Pedigree £10 I/we the breeders of the litter certify the particulars are true to the best of my/our knowledge and belief and agree to the following statements as listed below: n The litter was born in the United Kingdom at the address listed above (excluding in relation to all canine matters with which The Kennel Club PUPPY DOG BITCH COLOUR ENDORSEMENTS R X Jersey or Guernsey). is concerned. PREFERRED NAME n No dog listed in the application has been registered previously with The Kennel n I/we confirm and agree that any veterinary surgeon performing a caesarean Enhanced Pedigree £23 Club or any recognised body. section and/or an operation on any of my/our dogs in such a way that the ALTERNATIVE NAME 5 Generation Pedigree £10 n The dam has not had more than two caesareans in her lifetime and I/we have operation alters the natural conformation of the dog or any part thereof may 4 completed the caesarean section on this form if applicable. submit a report to The Kennel Club. MICROCHIP NO. 3 Generation Pedigree £10 n I/we are bound by and submit to The Kennel Club rules and regulations and general n I/we confirm we have checked and understood the legislation as required code of ethics in their present form or as they may be amended from time to time by law, in relation to dog breeding licences. PUPPY DOG BITCH COLOUR ENDORSEMENTS R X In the case of joint ownership, all owners must sign PREFERRED NAME Enhanced Pedigree £23 APPLICANT AND ADDITIONAL 8 OWNER SIGNATURES DATE D D M M Y Y Y Y 5 ALTERNATIVE NAME 5 Generation Pedigree £10 2 REGISTERED NAME OF DAM OF LITTER KC REG. NUMBER MICROCHIP NO. 3 Generation Pedigree £10

PUPPY DOG BITCH COLOUR ENDORSEMENTS R X MICROCHIP NO. 3 BREED PREFERRED NAME Enhanced Pedigree £23 4 LITTER DATE OF BIRTH 5 LITTER DATE OF MATING 6 KENNEL NAME 6 ALTERNATIVE NAME 5 Generation Pedigree £10 D D M M Y Y Y Y D D M M Y Y Y Y MICROCHIP NO. 3 Generation Pedigree £10

7 SIRE OWNER(S) NAME & ADDRESS PUPPY DOG BITCH COLOUR ENDORSEMENTS R X TITLE FIRST NAME / INITIALS LAST NAME PREFERRED NAME Enhanced Pedigree £23 ADDRESS 7 ALTERNATIVE NAME 5 Generation Pedigree £10 POST CODE MICROCHIP NO. 3 Generation Pedigree £10 TELEPHONE No.

EMAIL ADDRESS PUPPY DOG BITCH COLOUR ENDORSEMENTS R X CONFIRMATION OF MATING TO BE SIGNED BY OWNER(S) OF SIRE I/we have read the instructions for completion of this form and agree to be PREFERRED NAME Enhanced Pedigree £23 I/we hereby certify that the dam named as identified to me/us was mated to the sire on bound by and submit to The Kennel Club Rules and Regulations as the same the date indicated and that the sire was recorded as owned by me/us on that date. may be amended from time to time. ALTERNATIVE NAME 5 Generation Pedigree £10 8 MICROCHIP NO. 3 Generation Pedigree £10 In the case of joint ownership, all owners must sign

Should you wish to register more than 8 puppies please complete a second form. SIRE OWNER(S) SIGNATURE(S) 8 DATE D D M M Y Y Y Y In the event that both choices of names are not acceptable, The Kennel Club will select a name unless you initial this box. 8 REGISTERED NAME OF SIRE OF LITTER THE KENNEL CLUB REG. NUMBER 13 HOW TO PAY Total pedigrees £ A. By debit or credit card. Please charge my MICROCHIP NO. 9 ARTIFICIAL INSEMINATION (see section 9) Please tick here if your litter was bred using artificial insemination Total number of puppies: Visa MasterCard Delta 10 CAESAREAN SECTION (see section 10) Please tick here if your litter was born by Emergency or Elective Caesarean Section Card number Dogs Bitches at £15 each total £ Please provide any previous dates of litters born by caesarean section D D M M Y Y Y Y D D M M Y Y Y Y

11 ADDITIONAL ITEMS & FEES (PLEASE TICK RELEVANT BOX) Total additional items £ Expiry date of card Issue number Card security Check the current legislation as required by law, in relation to dog breeding licences. Visit thekennelclub.org.uk/breeding-licence (if printed The last 3 numbers on / on card) reverse of the card Breed Records Supplement (sent separately) £8 Record overseas sire (See section 8) Grand total £ If you require a VAT invoice please tick here. Three Generation Pedigree £20 Puppy naming service (See section 13) B. By cheque. I enclose a cheque made payable to: ‘The Kennel Club Limited’ (free to Kennel Name holders) £20 Five Generation Pedigree £25 We aim to deliver within 14 days, however, please note failure to fully SIGNATURE complete the application form and/or include the correct payment will Once your litter is registered, we will send an email BREEDER LICENCE NUMBER LICENSING AUTHORITY result in delaying the registration process and the application form may have to be sent back to you. enabling you to upload a photo. DATE D D M M Y Y Y Y FOR OFFICE USE ONLY Form 1 REGRISTRATION NO. Register your litter quickly and efficiently online at thekennelclub.org.uk/registrations

PUPPY DOG BITCH COLOUR ENDORSEMENTS R X

PREFERRED NAME Enhanced Pedigree £23 Your privacy is very important and we retain your data in accordance with our privacy notice which can be found on The Kennel Club website thekennelclub.org.uk 1 ALTERNATIVE NAME 5 Generation Pedigree £10 1 BREEDER(S) NAME & ADDRESS MICROCHIP NO. 3 Generation Pedigree £10 TITLE FIRST NAME / INITIALS LAST NAME

ADDRESS PUPPY DOG BITCH COLOUR ENDORSEMENTS R X

POST CODE PREFERRED NAME Enhanced Pedigree £23 TELEPHONE No. Breeding licence? Yes No If yes, please provide a copy 2 ALTERNATIVE NAME 5 Generation Pedigree £10 EMAIL ADDRESS MICROCHIP NO. 3 Generation Pedigree £10 ADDITIONAL OWNERS - PLEASE LIST ANY OTHER OWNERS OF THE DAM AT THE DATE OF BIRTH OF THE PUPPIES

TITLE FIRST NAME / INITIALS LAST NAME EMAIL (OPTIONAL) PUPPY DOG BITCH COLOUR ENDORSEMENTS R X

PUPPY DOG BITCH COLOUR ENDORSEMENTS R X MICROCHIP NO. 3 BREED PREFERRED NAME Enhanced Pedigree £23 4 LITTER DATE OF BIRTH 5 LITTER DATE OF MATING 6 KENNEL NAME 6 ALTERNATIVE NAME 5 Generation Pedigree £10 DDMMYYYY DDMMYYYY MICROCHIP NO. 3 Generation Pedigree £10

7 SIRE OWNER(S) NAME & ADDRESS PUPPY DOG BITCH COLOUR ENDORSEMENTS R X

TITLE FIRST NAME / INITIALS LAST NAME PREFERRED NAME Enhanced Pedigree £23 ADDRESS 7 ALTERNATIVE NAME 5 Generation Pedigree £10 POST CODE MICROCHIP NO. 3 Generation Pedigree £10 TELEPHONE No. EMAIL ADDRESS PUPPY DOG BITCH COLOUR ENDORSEMENTS R X

CONFIRMATION OF MATING TO BE SIGNED BY OWNER(S) OF SIRE I/we have read the instructions for completion of this form and agree to be PREFERRED NAME Enhanced Pedigree £23 I/we hereby certify that the dam named as identified to me/us was mated to the sire on bound by and submit to The Kennel Club Rules and Regulations as the same the date indicated and that the sire was recorded as owned by me/us on that date. may be amended from time to time. 8 ALTERNATIVE NAME 5 Generation Pedigree £10 MICROCHIP NO. 3 Generation Pedigree £10 In the case of joint ownership, all owners must sign Should you wish to register more than 8 puppies please complete a second form. SIRE OWNER(S) SIGNATURE(S) 8 DATE D D M M Y Y Y Y In the event that both choices of names are not acceptable, The Kennel Club will select a name unless you initial this box. 8 REGISTERED NAME OF SIRE OF LITTER THE KENNEL CLUB REG. NUMBER 13 HOW TO PAY Total pedigrees £ A. By debit or credit card. Please charge my MICROCHIP NO. 9 ARTIFICIAL INSEMINATION (see section 9) Please tick here if your litter was bred using artificial insemination Total number of puppies: Visa MasterCard Delta 10 CAESAREAN SECTION (see section 10) Please tick here if your litter was born by Emergency or Elective Caesarean Section Card number Dogs Bitches at £17 each total £ Please provide any previous dates of litters born by caesarean section D D M M Y Y Y Y D D M M Y Y Y Y

Breach of these provisions may result in expulsion from Club membership and/or disciplinary action by The Kennel Club and/or reporting to the relevant authorities for legal action, as appropriate.

The Kennel Club, Kennel Club House, Gatehouse Way, Aylesbury, HP19 8DB Telephone 01296 318540 • thekennelclub.org.uk

The Kennel Club Limited Incorporated in England and Wales Registered No: 8217778 Clarges Street, London, W1J 8AB VAT No: 239096833

KC/102/06/20 All information is correct at time of printing