New Jersey Pine Barrens Golden Retriever Club

NEW JERSEY PINE BARRENS GOLDEN RETRIEVER CLUB

20th ANNUAL HEART, EYE & MICROCHIP CLINIC

Heart: Dr. Megan Sleeper

Eyes: Dr. James Clinton

Home Again Microchips

When: Sunday, March 12, 2017

Where: Garden State Animal Hospital

628 Haddonfield Road, Cherry Hill NJ

** Pre-Registration is required ** Note Early Bird Pricing Below!

Please mail form with check payable to the “NJPBGRC” to: Stephanie Schiappa, 511 Pitman Avenue, Pitman NJ 08071

Phone: 856-589-5301 Fax: 856-533-3433

E-mail: or (gets to the same place)

DIRECTIONS TO GARDEN STATE ANIMAL HOSPITAL

From North: NJ Turnpike to Exit 4. Bare right onto Rt. 73 North, follow to Rt. 295 South and Exit at Rt. 70 West. Follow approx. 2 miles and turn right onto Haddonfield Rd. Follow Haddonfield Rd 3/4 mile to Garden State Animal Hospital on the right. Cherry’s Water Ice will be on the corner.

From South: NJ Turnpike to Exit 4. Follow directions above

From Rt. 295: Route 295, North or South to Rt. 70 West exit. Follow directions above.

From Philadelphia/West and Rt. 38: Follow Ben Franklin Bridge into NJ and bare left onto Rt. 30 E. Follow Rt. 30 E to Rt. 38 E/Kaighn Ave. Follow for approximately 3 miles. Take Haddonfield Road South ramp toward Haddonfield. Follow 3/4 mile and Garden State Animal Hospital will be on the left. Cherry’s Water Ice will be on the corner.

** Please be sure to print clearly so we may contact you with your scheduled appointment **

*** you will be notified on Approximately March 8th with your scheduled time **

Early Bird Pricing: Must receive Registration on or before March 6, 2017

Heart: #______@ $43 = $______Name: ______

Eye: #______@ $38= $______Address: ______

Microchip: # ______@ $25 = $______

Total: $ ______Phone: ______

Email: ______

Regular Pricing for registration received Time Preferred: ______

On or After March 7, 2017 Breed ______

Heart: #______@ $45 = $______

Eye: #______@ $43 = $______

Microchip: #______@ $30 = $ ______

Total: $______