PACK LLAMA TRIAL ASSOCIATION

P.O. Box 388 Garberville, CA 95542 (707) 923-1016 cornomike@gotsky.com

In order for your animal to be eligible for certification, a one time registration fee per llama is required for entry into sanctioned PLTA trials. Once registered, you will be issued a number to be used on future trial entry forms.

Llama Registration Form

(Please Print)

Full Name of Llama: ________________________________________________________

ILR #: ____________ Date of Birth: ______________ Sex: Male Female Gelding

(Circle One)

Owner's Name: ____________________________________________________________

Address: __________________________________________________________________

City_______________________________State_____________Zip___________

Phone: ______________________________

E-Mail: ___________________________________________________________________

I certify that all information on this form is correct and appropriate to the llama listed

Owner or Owner Agent Signature:________________________________________________

Please make your check in the amount of $10.00 payable to the PLTA and return to:

PLTA

P.O. Box 388

Garberville,CA 95542

For Office Use Only:

Date Received: Animal Registration #:___________

Revised 9/2007