The American Pit Bull Registry
PO Box 1036 Antioch, TN 37011
www.PitBullRegistry.com
Registration Form
Referred By:
Name of Sire
APBR# if applicable
Alternative Registering Organizations and Numbers:
Organization
Number
Organization
Number
Organization
Number
Owner Name
E-Mail if available
Name of Dam
APBR# if applicable
Alternative Registering Organizations and Numbers:
Organization
Number
Organization
Number
Organization
Number
Owner Name
E-Mail if available
*Owner Name
E-mail
*Name of dog to be registered
*Address
*State
*ZIP
Pits date of birth
*Description of Pit:
Male
*City
Area Code
Phone
State and Country of birth
Female
Bloodline if Known
*Physical Characteristics:
Registration Fee $20.00 Adoptive Registration Fee $6.00 with proof from
adoption agency. Discount rates available for multiple Pit registration.
Payment may be made to The American Pit Bull Registry in the form of Check, Money
Order or by using the Pay Pal Debit/Credit Online Card System. We offer multiple Pit
Registration Discounts for those wishing to register more than one Pit. Please see web site
Payment Schedule.
Paying By:
Check
Money Order
OR
Internet Debit / Credit PayPal
Registered under litter name:
I certify that all the information is, to the best of my knowledge true and correct. I
understand that any falsified information may subject me to legal action and loss of
registration privileges.
*Signature
*Date
In order to register your Pit Bull you must also send a front and side picture to be
reviewed by our registering agents. These pictures may be sent via E-Mail or standard
mail. If you would like you may include additional pictures and video for the purpose of
future breeding prospects and review. All material sent will become the property of The
American Pit Bull Registry (APBR) and may be used in future use, advertising material,
or as otherwise seen fit.
You may also wish to send any additional information you have in regards to your Pit
Bull. Any history, genealogy, pictures, video, stories, etc. This additional information may
be made to others who wish to breed with your Pit Bull in the future or in the
development of expanded pedigrees. For those who choose to breed, please do so
responsibly. We suggest that you read our section at www.PitBullRegistry.com on
Breeding and Ownership before you begin the process.