Pre-Registration
Free Rabies Vaccination Event for Dogs and Cats:
Fort Greene Park
Dekalb Avenue and Portland Avenue
Brooklyn, NY 11217

Date: Sunday, April 30, 2017
Time: 10:00 AM to 2:00 PM

Pre-registration is required due to limited vaccine supply.
Dogs and cats with a history of allergic reaction to the vaccine will not be vaccinated.

You can also purchase a dog license at this event, and get your tag right away! Checks, money orders and credit cards are accepted.

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* 1. I would like to:

Cancel my prior registration

Other (please specify)

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* 2. Contact Information:

First Name *

Last Name

Email Address

Phone Number *

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* 3. When would you like to book your appointment?

	10 AM to 11 AM	11 AM to 12 PM	12 PM to 1 PM	1 PM to 2 PM
I would like to book my appointment from	I would like to book my appointment from 10 AM to 11 AM	I would like to book my appointment from 11 AM to 12 PM	I would like to book my appointment from 12 PM to 1 PM	I would like to book my appointment from 1 PM to 2 PM

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* 4. Please choose the number of dog(s) and cat(s) you would like to bring for vaccination during this event; remember, the total can't exceed 10:

	Number of pets needed vaccination
- Dog(s)	- Dog(s) Number of pets needed vaccination menu
- Cat(s)	- Cat(s) Number of pets needed vaccination menu