Consent Form
I understand that the DPCA has signed an Agreement with the Ralston Purina Company whereby Purina will provide significant monetary support to the DPCA Futurity Program and also to educational and health-related projects designated by the DPCA. I further understand that under this agreement Purina will be supplied with my name and address and my litter and/or puppy(ies) will be "registered" under this program for purposes of tracking AKC Championship titles and the promulgation of promotional material as well as awards related to those titles. I further understand that under the agreement with the DPCA, Purina has agreed that my name and address is confidential and that Purina will not make my name and/or address available to any other person or organization but will merely maintain my name and address in the Purina database for purposes of contacting me about promotional opportunities. I consent to the DPCA providing my name and address to Purina for these purposes.
Dated: ________________
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Signature
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Print Name
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Street
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City, State, Zip
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