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Animal Registration


First Name^*
Last Name^*
Address^*
City^*
State^*
Zip^*
Phone
E-mail
Registration Fee		$5
Impound Fee		$25.00
Daily Storage Fees
Registration Tag #^*
Vaccination Tag #
Animal Name^*
Photo
Species^*
Gender
Age
Size
Predominant Breed^*
Color(s)
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