OFFICIAL ON-LINE REGISTRATION FORM Handling Seminar, April 7, 2002 German Shepherd Dog Club of Manitoba Winnipeg, Manitoba, Canada Person $ 30.00 Prices include lunch and coffee breaks. Couple $ 50.00 Junior $ 15.00 x   Handling Manual $ 15.00 x   Spectator $ 10.00 x   TOTAL $   Breed of Dog   Name(s) Address City Province   Postal Code Telephone Number

Payment Method (Please choose one and fill out the appropriate section) DIRECT PAYMENT     CREDIT CARD Direct Payment We wish to promote this new service and we are offering a reduction of our service charges. All direct payments are subject to a service charge of 7% of total payment to the host club (GST included). This service is only available for Canadian financial institutions. More information here.   Method Internet Banking Telephone Banking ATM (Automated Teller Machine) Teller Name of Bank G.o.T.o. Account #   (More information here)   Upon submission of this registration form, please proceed to make your payment using the method of choice. PLEASE REMEMBER TO ADD 7% TO YOUR TOTAL! Registration will not be accepted unless total payment is received.   Credit Card All credit card payments will be assessed a service charge of 10% of total payment to the host club (GST included). Please Note: We are a credit card merchant that is AUTHORIZED to accept credit card payments on behalf of a third party (the host club).   Credit Card Visa MasterCard American Express Card #  (*optional) Expiry Date Card Holder Name   *This form is being submitted by e-mail and will not be encrypted for privacy. Please proceed at your own risk. If you wish, you may omit your credit card number on this registration form and telephone Gina Ostroman with the CREDIT CARD NUMBER ONLY. In Winnipeg and surrounding areas phone 444-GoTo (4686). Long distance callers may phone toll free 1-866-444-GoTo (4686). All payments processed by G.o.T.o. and your statements will reflect this information. Tendering of a declined credit card, telephone or Internet banking payment shall be considered non-payment. There will be a $20.00 fee charged for all declined credit cards, telephone or Internet banking payments.

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It is EXTREMELY IMPORTANT that you enter an accurate and valid e-mail address in the field above. Upon submission of this registration form you will receive an registration confirmation via e-mail. If you do not receive a confirmation e-mail, there may be a problem processing your registration. In such an event, please contact the Web Master at webmaster@goto-enter.com