The Carroll County Kennel Club of New Hampshire

Presents All-Breed CERF Eye Clinic with Nick Cassotis, DVM Diplomate American College of Veterinary Ophthalmologists

Saturday, March 26, 2011 Telling Tails Training Center 285 Main Street, Fryeburg, Maine 04037

Pre-registration is required! Registration and payments must be received by March 22, 2011. After March 22, call for availability (603) 284-7108. Please circle the window of time you prefer for an appointment, indicating your first & second choices; we will make every effort to accommodate you. You MUST include a Self-Addressed Stamped Envelope or E-Mail address with your Exam Fees. Your appointment time will be mailed or e-mailed to you.

Make checks payable to Carroll County Kennel Club. Please arrive at least 15 minutes prior to your eye exam appointment so that eye drops can be administered. Bring your dog’s AKC registration, permanent ID information, and copy of prior ophthalmologic exam (if any) for CERF forms.

Please complete the following information. (Please type or print legibly.)

Owner Name:______Address:______Phone #:______E-Mail Address:______Dog’s Call Name(s)______Breed(s):______

# Dogs for Eye Exam:______@$30/dog = $______

Total due payable to Carroll County Kennel Club: $______Refunds will be issued only with 24 hour’s notice of cancellation. Due to a full schedule of events at Telling Tails, the CERF Clinic will begin at 2 PM Please circle requested time slot indicating 1st and 2nd choice:

2-3 PM 3-4 PM 4-5 PM

Send with Payment to Diana Barrie, CCKC, PO Box 74, North Sandwich, NH 03259-0074

Directions to Telling Tails: From North or South – Take Rt. 16 to Conway to Rt. 113/302 to Fryeburg, Me. Telling Tails is located approx. ½ mile from NH/Maine border on the Right. From the East – Take Rt. 302 thru Fryeburg to Telling Tails located approx. ½ mile from Fryeburg village on the Left.