The 79 th NATIONAL SPECIALTY AKC LURE COURSING TESTS AND TRIAL AFGHAN HOUNDS ONLY Afghan Hound Club of America, Inc.

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1 PREMIUM LISTS Event # Junior Courser Test A Qualified Courser Test Trial Event # Junior Courser Test B The 79 th NATIONAL SPECIALTY AKC LURE COURSING TESTS AND TRIAL AFGHAN HOUNDS ONLY Afghan Hound Club of America, Inc. National Specialty (Member of the American Kennel Club) Sunday - October 18, 2015 Chattahoochee Hills-Bouckaert Farm 9445 Browns Lake Rd., Fairburn, GA TRIAL ENTRIES CLOSE AT 8 PM WEDNESDAY, SEPTEMBER 30, 2015 Test Entries close 15 minutes prior to roll calls Entries will NOT be Acknowledged by Mail Cell Phone at Trial Site: **THIS FIELD IS ON AN 8,000 ACRE ESTATE, OVER A MILE FROM ANY PUBLIC ROAD AND ENCLOSED BY NATURAL BOUNDARIES. IT IS NOT FENCED. ** AKC REQUIRES MINIMUM 3PTS TO ENTER FIELD TRIAL OPEN STAKE Permission has been granted by the American Kennel Club for the Holding of this event under American Kennel Club Rules and Regulations James P. Crowley, Secretary

2 ROLL CALLS QC Test and JC Test (A) - 11:30 AM Trial 12:00 PM JC Test (B) 2:00 PM Trial Hours 7:00 am to conclusion of trial awards ceremony Canidae Dog Food will be providing training teats to everyone at roll call. ENTRY FEES (including a $3.00 AKC Event Service Fee) Separate fee for each hound; each stake/test; each trial Trial (Pre-entry only).. first dog...$30.00 Each Additional dog same household... $25.00 JC & QC Test (Pre-entry) $25.00 JC & QC Test (Day of Trial-entry) $30.00 Make checks payable to AHCA Mail pre entries to Trial Secretary: Linda Jordan 1494 Baker Rd., Martinsburg, WV windcrest2@gmail.com OFFICERS PRESIDENT Tony Saia 1ST VICE PRESIDENT Jennifer Taylor 2ND VICE PRESIDENT Ken Amos TREASURER..... Robert Jordan RECORDING SECRETARY Eileen Laudermilch CORRESPONDING SECRETARY... Dorma Sue Busby Plumbrook Rd., Sterling Hgts,., MI Board of Directors Russ Hastings Linda Jackson Jay Johnson Sharon Pearce Allan Reznik Abbe Shaw FIELD COMMITTEE (In response to unforeseen circumstances, committee members may be substituted as necessary) TRIAL CHAIRMAN Baker Rd., Martinsburg, WV Robert Jordan TRIAL SECRETARY Robert Jordan 1494 Baker Rd., Martinsburg, WV windcrest2@gmail.com LURE OPERATOR...Robert Jordan, John Parker, Eddie Kominak HUNTMASTER....Alexandra Treadaway, Jeanie Martin, Michelle Trifiro RECORDS DESK & FIELD CLERKS... Linda Jordan, Ann Nicholson INSPECTION... Jeanie Martin, Brenda Burns, Ann Nicholson JUDGES Donna Richards Lantana Dr., Denver, NC Trial Test A Dean Wright Baltimore St., Hanover, PA Trial Test B 2

3 PRIZES Best in Event...Red, White & Blue Rosette, 6 Gary Newton Bronze, Wine Basket, By Linda Rana and a $100 Voucher from Laser Lites America, and a 24# bag of Canidae Dog Food Best of Breed......Purple & Gold Rosette, 3" Terry d. Chacon Bronze & Matted Framed Afghan Print and a 12# Bag of Canidae Dog Food First Place Blue Rosette & 2 AHCA Medallion on Blue Ribbon and Small Afghan Hound Print Second Place...Red Rosette & 2 AHCA Medallion on Red Ribbon & Dog Toy Third Place,...Yellow Rosette & 2 AHCA Medallion on Yellow Ribbon& Dog Toy Fourth Place...White Rosette & 2 AHCA Medallion on White Ribbon& Dog Toy Fifth Place...Pink Rosette & 2 AHCA Medallion on Pink Ribbon& Dog Toy Junior Courser Qualifier Green Rosette High Scoring AKC Champion of Record & Oldest Qualifying Veteran In Event Green Rosette TESTS & STAKES OFFERED JUNIOR COURSER TEST: Open to all Afghan Hounds at least 12 months of age. A hound running alone shall receive a certification from a judge assigned to one test and a second certification from a different judge assigned to another test, stating that the hound completed a 600-yard course with a minimum of four turns. The hound must complete the course with enthusiasm and without interruption. QUALIFIED COURSER TEST: Open to all Afghan Hounds at least 12 months of age (Qualifying Hound) running with another hound of the same breed or another breed with a similar running style (Testing Hound) shall receive certification from a licensed judge. The hound must complete the course with enthusiasm and without interruption, sufficiently course the lure and not course the Testing Hound. The judge will certify that the Qualifying Hound ran cleanly and did not appear to present a hazard to the Testing Hound at any point in the qualifying course. The handler presenting the Qualifying Hound shall be responsible for providing the Testing Hound for the qualifying course. OPEN STAKE (trial): Open to any eligible Afghan Hound that has obtained an AKC Qualified Courser certificate prior to close of entries. QC Certificate must be submitted to the host club along with the entry form the first time the hound is entered in the AKC Open Stake. This requirement will be waived for hounds that have earned a Field Championship title from the American Sighthound Field Association (ASFA) or the Canadian Kennel Club (CKC). A copy of the hound s ASFA or CKC Field Champion Certificate must be submitted to the host club along with the entry form the first time the hound is entered in the AKC Open Stake SPECIALS STAKE (trial): Open to any eligible Afghan Hound that has earned their AKC Field Championship title. OPEN VETERAN STAKE (trial): Open to any Afghan Hound which is eligible to enter Open or Special stakes and is 7 years or older on the day of the trial. BEST IN LURE FIELD TRIAL EVENT RUN-OFF BETWEEN ASFA AND AKC BOB WINNERS WILL BE OFFERED CURRENT POINTS SCHEDULE Points for First Place Number of Dogs in Competition Afghan Hounds When 1st place hound earns The 2nd place hound earns The 3rd place hound earns

4 AKC DISASTER/EMERGENCY INFORMATION SECURITY PERSONNEL: Robert Jordan Ambulance: Hospital Ambulance of Georgia OR 911 Fire Department: Palmetto Fire Department OR 911 Police Department: Fairburn City Police Dept Hospital: Wellstar Douglas Hospital Hospital Dr., Douglasville, Ga Veterinarian: Banfield Pet Hospital (on call) 2701 Hwy. 54, Peachtree City, Ga Directions to Veterinarian: Go South on Browns Lake Rd toward Cedar Grove Rd / GA- 0.8 mi Turn left onto Cedar Grove Rd / GA mi Turn slight right onto Cascade Palmetto Hwy / GA mi Turn right onto Roosevelt Hwy / US-29 / GA-154 / GA mi Turn left onto Weldon Rd. 0.3 mi Take the 2nd right onto Palmetto-Tyrone Rd. 1.3 mi Turn right onto Fischer Rd / Fisher Rd. 6.6 mi Turn left onto GA-34 E. 0.3 mi Turn left onto Huddleston Rd. (Hwy. 54) 0.01 mi HOTELS & MOTELS THAT ACCEPT DOGS Sheraton Atlanta Airport-, 1900 Sullivan Rd., Atlanta, Ga (National Specialty Host Hotel 18 mi $100 Pet deposit, but no fee) Country Inn Suites Fairburn, 7815 Senoia Rd., Fairburn, Ga (10 mi) Country Inn SuitesPet fee $30.00 Econo-Lodge,7410 Oakley Rd,Union City,Ga (Pet Fee $10 per dog-13 mi) LaQuinta, 600 Bullsboro Dr., Newnan, Ga (no pet fee - 20 mi) COURSE DESIGN The club reserves the right to alter the course diagram as required by weather and/or field conditions on the day of the trial 4

5 NOTICE TO ALL EXHIBITORS All entries must be one year of age or older on the day of the trial. Only purebred Afghan Hounds which are registered with the AKC or have an AKC ILP number may be entered. Each hound requires an individual entry form for each event in which it is entered. No entry shall be made and no entry shall be accepted which specifies any condition as to its acceptance. Entries will not be accepted without fees, signatures or the Agreement found on the Official AKC Entry Form. Stakes will be split if sufficient entries are present in any one stake at the time of the draw for two or more 5-point majors. Splitting of stakes will be held publicly and at the FTS desk. Hounds disqualified from AKC, ASFA or CKC Field Trials may be entered in the Junior Coursing Tests. All hounds will run twice, in trios if possible or braces, unless excused, dismissed or disqualified. At time of inspection, bitches in season, hounds with breed disqualifications, and lame hounds will be excused and their entry fee refunded. Monorchid and cryptorchid hounds may not be entered. Spayed or neutered hounds (without breed disqualifications) may be entered. Hounds not present at roll call will be scratched, and entry fees will not be refunded. Battery powered, continuous loop lure machines will be used. The lure will consist of plastic contrasting in color with the immediate field environment. Muzzles are not required; it is the responsibility of the owners to determine if their hound should be muzzled. Exhibitors should follow their veterinarian s recommendation to assure their dogs are free of internal and external parasites, any communicable diseases and have appropriate vaccinations. No entry fees will be refunded if the event cannot be started or completed by reason of riots, civil disturbances, fire, extreme and/or dangerous weather conditions, an Act of God, public emergency, act of a public enemy, strikes or any other cause beyond the control of the Club or its members and representatives. Persons exhibiting conduct detrimental to AKC/AHCA/any hound(s)/other person(s) will be asked to leave the trial site. The event-hosting club, its agents, members, representatives, volunteers, etc, assume no responsibility for any loss, damage or injury sustained by exhibitors, handlers, or to any of their dogs or property and further assumes no responsibility for injury to children or spectators. All rights to televise, videotape, advertise, photograph, promote or otherwise exploit this event are vested in the club, or in persons to whom assignments of such rights have been made in writing by the club. All persons and animals attending these shows grant the club the right to use their likeness and voice in any matter without further consent. A penalty of $5.00 will be assessed for any loose hounds not competing in the course in progress. A return check fee of $35.00 will be assessed for any check(s) returned for insufficient funds. All hounds to be inspected for entry in the AKC JC or QC Test(s) and/or Trials must be presented without tape, bandages or wrapping on the toes, feet, or legs. Committee members may request that cold-weather coverings such as blankets, coats and pajamas be removed from hounds under inspection. Field Committee Members and Trial Volunteers may have their hounds inspected prior to the designated inspection time by the full inspection committee. Concumption of alcoholic beverages is not allowed. OFFICIAL PHOTOGRAPHER PHYLLIS ENSLEY PHOTOGRAPHY 1235 Lower Burris Road, Canton, GA (888) dog-pics phyllisensleyphotography.com 5

6 IMPORTANT Facility Information By kind permission of Mr. Carl Bouckaert, this trial will be held at Chattahoochee Hills/Bouckaert Farm, near Fairburn, Georgia, an 8,000-acre equestrian eventing estate on the banks of the Chattahoochee River, just 15 miles west of the Atlanta airport. PLEASE NOTE: Once you have entered the farm and are on the one-lane farm road leading to the field, please watch for horses and riders, who have the right of way at all times. Please greet all riders graciously, as one of them might be Mr. Bouckaert, our generous host! Attention drivers of RVs and travel trailers: The one-lane farm road leading from the entrance off the farm to the field, a distance of 1.7 miles, is gravel surfaced in some areas and dirt in other areas, and may prove problematic for transit by heavy vehicles if there has been recent rain. Please call the Field Trial Chairman ( ) 24 hours before the trial for an advisory on RV access. Please ensure comfort for you and your hounds by bringing SHADE and WATER for your hounds. Pop-up tents are allowed during the day of the trial. AHCA will provide exhibitors hospitality with complimentary breakfast, lunch, water and soda. Portable restrooms will be made available Camping is NOT available at the field.. Directions From I-85 heading North (as from the motels in Newnan): Take Exit 61 (Hwy. 74/Fairburn); at the end of the ramp, turn left heading North on Hwy. 74. When the two-lane highway turns into a single lane, stay straight (do not continue on Hwy. 74 go straight) for 3 miles until the road dead ends into Rivertown Road. Turn left onto Rivertown Road and go 3.5miles to South Fulton Parkway. Cross over South Fulton Parkway, staying on Rivertown Road for 2 miles, then turn right at the 4-way stop onto Cochran Mill Road. Go for 3 miles, then turn left at the 4-way stop onto Cedar Grove Road and go 1/10 of a mile to a right turn onto Brown s Lake Road. Go 1.3 mile on Brown s Lake Road to a stop sign. Bear right onto the gravel road, and from there follow field trial signs to the field. From I-75 North & South of Atlanta: Take I-285 West to Exit 62 (Spur 14 / South Fulton Parkway); see below. From I-20 East or West: Take I-285 heading South to Exit 62 (Spur 14 / South Fulton Parkway); see below From I-85 heading South (as from the Atlanta airport / Sheradon Hotel area): Take exit 69 (spur 14/ South Fulton Parkway; see below. On South Fulton Parkway: Go 12 miles on South Fulton Parkway, then turn right on Rivertown Road. Go for 2 miles, then turn right at the 4-way stop onto Cochran Mill Road. Go for 3 miles, then turn left at the 4-way stop onto Cedar Grove Road and go 0.1 m ile to a right turn onto Brown s Lake Road. Go 1.3 mile on Brown s Lake Road to a stop sign. Bear right onto the gravel road, and from there follow field trial signs to the field. 6

7 OFFICIAL AMERICAN KENNEL CLUB LURE COURSING ENTRY FORM Club: AFGHAN HOUND CLUB OF AMERICA Date: October 18, 2015 Event#: & Location: Event type (test or trial): Bouckaert Farm, Fairburn, Ga. Test Trial Stakes: JC QC Open Specials Veteran Breed: I enclose entry fees in the amt $ CALL NAME: AKC No.: Sex Date of Birth: Breeder: Full Name of Dog: AKC # AKC Litter # ILP # Foreign# / Country Sire: Dam: Actual Owner(s): Owner s Address: City State Zip: Name of Owner s Agent (If any) at trials PLEASE SEPARATE MY ENTRIES AKC Rules, Regulations, Policies and Guidelines are available on the AKC website: AGREEMENT I certify that I am the actual owner of the dog, or that I am the duly authorized agent of the actual owner whose name I have entered above. In consideration of the acceptance of this entry, I (we) agree to abide by the rules and regulations of The American Kennel Club in effect at the time of this event, and any additional rules and regulations appearing in the premium list of this event and entry form and a ny decision made in accord with them. I (we) agree that the club holding this event has the right to refuse this entry for cause which the club shall deem sufficient. In consideration of the acceptance of this entry and of the holding of this event and of the opportunity to have the dog judged and to win prizes, ribbons, or trophies, I (we) agree to hold the AKC, the event-giving club, their members, directors, governors, officers, agents, superintendents or event secretary and the owner and/or lessor of the premises and any provider of services that are necessary to hold this event and any employees or volunteers of the aforementioned parties, and any AKC approved judge, judging at this event, harmless from any claim for loss or injury which may be alleged to have been caused directly or indirectly to any person or thing by the act of this dog while in or about the event premises or grounds or near any entrance thereto, and I (we) personally assume all responsibility and liabili ty for any such claim; and I (we) further agree to hold the aforementioned parties harmless from any claim for loss, injury or damage to this dog. Additionally, I (we) hereby assume the sole responsibility for and agree to indemnify, defend and save the aforementioned parties harmless from any and all loss and expense (including legal fees) by reason of the liability imposed by law upon any of the aforementioned parties for damage because of bodily injuries, including death at any time resulting there from, sustained by any person or persons, including myself (ourselves), or on account of damage to property, arising out of or in consequence of my (our) participation in this event, however such, injuries, death or property damage may be caused, and whether or not the same may have been caused or may be alleged to have been caused by the negligence of the aforementioned parties or any of their employees, agents, or any other persons. I (WE) AGREE THAT ANY CAUSE OF ACTION, CONTROVERSY OR CLAIM ARISING OUT OF OR RELATED TO THE ENTRY, EXHIBITION OR ATTENDANCE AT THE EVENT BETWEEN THE AKC AND THE EVENTGIVING CLUB (UNLESS OTHERWISE STATED IN TIS PREMIUM LIST) AND MYSELF (OURSELVES) OR AS TO THE CONSTRUCTION, INTERPRETATION AND EFFECT OF THIS AGREEMENT SHALL BE SETTLED BY ARBITRATION PURSUANT TO THE APPLICABLE RULES OF THE AMERICAN ARBITRATION ASSOCIATION. HOWEVER, PRIOR TO ARBITRATION ALL APPLICABLE AKC BYLAWS, RULES, REGULATIONS AND PROCEDURES MUST FIRST BE FOLLOWED AS SET FORTH IN THE AKC CHARTER AND BYLAWS, RULES, REGULATIONS, PUBLISHED POLICIES AND GUIDELINES. Signature of Owner or Agent Duly authorized to make ths entry: Telephone: 7

8 Qualified Courser Certificate Instructions: This form is to be used when a hound successfully completes the Qualified Courser Test at an AKC Lure Coursing event. A hound must have received this certification within one year of the closing date of the trial being entered to be eligible to compete in an AKC Lure Coursing Trial in the Open or Open Veteran stake. This form must be properly completed and submitted along with this hound s first entry in an AKC Lure Coursing Trial in either stake. * Hounds who have earned a Field Championship from either the American Sighthound Field Association (ASFA) or the Canadian Kennel Club (CKC) are exempt from this requirement. A copy of the applicable FC certificate must accompany the first entry of these hounds. To be completed by owner/agent: Breed AKC Registered Name AKC Registration Number CALL NAME I hereby certify that the hound running in the Qualifying Course is the hound identified above and the information provided is true and correct. Printed Name of Owner/Agent Signature of Owner/Agent Date To be completed by certifying judge: I hereby certify that the above referenced hound passed the Qualified Courser Test by running clean with another hound of the same breed or one with a similar running style completing a course a minimum of 600 yards. Judge s Printed Name Judge s Signature Judge s Number Date 8 JERSC6 (8/09)

9 OFFICIAL AMERICAN KENNEL CLUB LURE COURSING ENTRY FORM Club: AFGHAN HOUND CLUB OF AMERICA Date: October 18, 2015 Event#: & Location: Event type (test or trial): Bouckaert Farm, Fairburn, Ga. Test Trial Stakes: JC QC Open Specials Veteran Breed: I enclose entry fees in the amt $ CALL NAME: AKC No.: Sex Date of Birth: Breeder: Full Name of Dog: AKC # AKC Litter # ILP # Foreign# / Country Sire: Dam: Actual Owner(s): Owner s Address: City State Zip: Name of Owner s Agent (If any) at trials PLEASE SEPARATE MY ENTRIES AKC Rules, Regulations, Policies and Guidelines are available on the AKC website: AGREEMENT I certify that I am the actual owner of the dog, or that I am the duly authorized agent of the actual owner whose name I have entered above. In consideration of the acceptance of this entry, I (we) agree to abide by the rules and regulations of The American Kennel Club in effect at the time of this event, and any additional rules and regulations appearing in the premium list of this event and entry form and a ny decision made in accord with them. I (we) agree that the club holding this event has the right to refuse this entry for cause which the club shall deem sufficient. In consideration of the acceptance of this entry and of the holding of this event and of the opportunity to have the dog judged and to win prizes, ribbons, or trophies, I (we) agree to hold the AKC, the event-giving club, their members, directors, governors, officers, agents, superintendents or event secretary and the owner and/or lessor of the premises and any provider of services that are necessary to hold this event and any employees or volunteers of the aforementioned parties, and any AKC approved judge, judging at this event, harmless from any claim for loss or injury which may be alleged to have been caused directly or indirectly to any person or thing by the act of this dog while in or about the event premises or grounds or near any entrance thereto, and I (we) personally assume all responsibility and liabili ty for any such claim; and I (we) further agree to hold the aforementioned parties harmless from any claim for loss, injury or damage to this dog. Additionally, I (we) hereby assume the sole responsibility for and agree to indemnify, defend and save the aforementioned parties harmless from any and all loss and expense (including legal fees) by reason of the liability imposed by law upon any of the aforementioned parties for damage because of bodily injuries, including death at any time resulting there from, sustained by any person or persons, including myself (ourselves), or on account of damage to property, arising out of or in consequence of my (our) participation in this event, however such, injuries, death or property damage may be caused, and whether or not the same may have been caused or may be alleged to have been caused by the negligence of the aforementioned parties or any of their employees, agents, or any other persons. I (WE) AGREE THAT ANY CAUSE OF ACTION, CONTROVERSY OR CLAIM ARISING OUT OF OR RELATED TO THE ENTRY, EXHIBITION OR ATTENDANCE AT THE EVENT BETWEEN THE AKC AND THE EVENTGIVING CLUB (UNLESS OTHERWISE STATED IN TIS PREMIUM LIST) AND MYSELF (OURSELVES) OR AS TO THE CONSTRUCTION, INTERPRETATION AND EFFECT OF THIS AGREEMENT SHALL BE SETTLED BY ARBITRATION PURSUANT TO THE APPLICABLE RULES OF THE AMERICAN ARBITRATION ASSOCIATION. HOWEVER, PRIOR TO ARBITRATION ALL APPLICABLE AKC BYLAWS, RULES, REGULATIONS AND PROCEDURES MUST FIRST BE FOLLOWED AS SET FORTH IN THE AKC CHARTER AND BYLAWS, RULES, REGULATIONS, PUBLISHED POLICIES AND GUIDELINES. Signature of Owner or Agent Duly authorized to make ths entry: Telephone: 9

10 Qualified Courser Certificate Instructions: This form is to be used when a hound successfully completes the Qualified Courser Test at an AKC Lure Coursing event. A hound must have received this certification within one year of the closing date of the trial being entered to be eligible to compete in an AKC Lure Coursing Trial in the Open or Open Veteran stake. This form must be properly completed and submitted along with this hound s first entry in an AKC Lure Coursing Trial in either stake. * Hounds who have earned a Field Championship from either the American Sighthound Field Association (ASFA) or the Canadian Kennel Club (CKC) are exempt from this requirement. A copy of the applicable FC certificate must accompany the first entry of these hounds. To be completed by owner/agent: Breed AKC Registered Name AKC Registration Number CALL NAME I hereby certify that the hound running in the Qualifying Course is the hound identified above and the information provided is true and correct. Printed Name of Owner/Agent Signature of Owner/Agent Date To be completed by certifying judge: I hereby certify that the above referenced hound passed the Qualified Courser Test by running clean with another hound of the same breed or one with a similar running style completing a course a minimum of 600 yards. Judge s Printed Name Judge s Signature Judge s Number Date 10 JERSC6 (8/09)

11 OFFICIAL AMERICAN KENNEL CLUB LURE COURSING ENTRY FORM Club: AFGHAN HOUND CLUB OF AMERICA Date: October 18, 2015 Event#: & Location: Event type (test or trial): Bouckaert Farm, Fairburn, Ga. Test Trial Stakes: JC QC Open Specials Veteran Breed: I enclose entry fees in the amt $ CALL NAME: AKC No.: Sex Date of Birth: Breeder: Full Name of Dog: AKC # AKC Litter # ILP # Foreign# / Country Sire: Dam: Actual Owner(s): Owner s Address: City State Zip: Name of Owner s Agent (If any) at trials PLEASE SEPARATE MY ENTRIES AKC Rules, Regulations, Policies and Guidelines are available on the AKC website: AGREEMENT I certify that I am the actual owner of the dog, or that I am the duly authorized agent of the actual owner whose name I have entered above. In consideration of the acceptance of this entry, I (we) agree to abide by the rules and regulations of The American Kennel Club in effect at the time of this event, and any additional rules and regulations appearing in the premium list of this event and entry form and a ny decision made in accord with them. I (we) agree that the club holding this event has the right to refuse this entry for cause which the club shall deem sufficient. In consideration of the acceptance of this entry and of the holding of this event and of the opportunity to have the dog judged and to win prizes, ribbons, or trophies, I (we) agree to hold the AKC, the event-giving club, their members, directors, governors, officers, agents, superintendents or event secretary and the owner and/or lessor of the premises and any provider of services that are necessary to hold this event and any employees or volunteers of the aforementioned parties, and any AKC approved judge, judging at this event, harmless from any claim for loss or injury which may be alleged to have been caused directly or indirectly to any person or thing by the act of this dog while in or about the event premises or grounds or near any entrance thereto, and I (we) personally assume all responsibility and liabili ty for any such claim; and I (we) further agree to hold the aforementioned parties harmless from any claim for loss, injury or damage to this dog. Additionally, I (we) hereby assume the sole responsibility for and agree to indemnify, defend and save the aforementioned parties harmless from any and all loss and expense (including legal fees) by reason of the liability imposed by law upon any of the aforementioned parties for damage because of bodily injuries, including death at any time resulting there from, sustained by any person or persons, including myself (ourselves), or on account of damage to property, arising out of or in consequence of my (our) participation in this event, however such, injuries, death or property damage may be caused, and whether or not the same may have been caused or may be alleged to have been caused by the negligence of the aforementioned parties or any of their employees, agents, or any other persons. I (WE) AGREE THAT ANY CAUSE OF ACTION, CONTROVERSY OR CLAIM ARISING OUT OF OR RELATED TO THE ENTRY, EXHIBITION OR ATTENDANCE AT THE EVENT BETWEEN THE AKC AND THE EVENTGIVING CLUB (UNLESS OTHERWISE STATED IN TIS PREMIUM LIST) AND MYSELF (OURSELVES) OR AS TO THE CONSTRUCTION, INTERPRETATION AND EFFECT OF THIS AGREEMENT SHALL BE SETTLED BY ARBITRATION PURSUANT TO THE APPLICABLE RULES OF THE AMERICAN ARBITRATION ASSOCIATION. HOWEVER, PRIOR TO ARBITRATION ALL APPLICABLE AKC BYLAWS, RULES, REGULATIONS AND PROCEDURES MUST FIRST BE FOLLOWED AS SET FORTH IN THE AKC CHARTER AND BYLAWS, RULES, REGULATIONS, PUBLISHED POLICIES AND GUIDELINES. Signature of Owner or Agent Duly authorized to make ths entry: Telephone: 11

12 Qualified Courser Certificate Instructions: This form is to be used when a hound successfully completes the Qualified Courser Test at an AKC Lure Coursing event. A hound must have received this certification within one year of the closing date of the trial being entered to be eligible to compete in an AKC Lure Coursing Trial in the Open or Open Veteran stake. This form must be properly completed and submitted along with this hound s first entry in an AKC Lure Coursing Trial in either stake. * Hounds who have earned a Field Championship from either the American Sighthound Field Association (ASFA) or the Canadian Kennel Club (CKC) are exempt from this requirement. A copy of the applicable FC certificate must accompany the first entry of these hounds. To be completed by owner/agent: Breed AKC Registered Name AKC Registration Number CALL NAME I hereby certify that the hound running in the Qualifying Course is the hound identified above and the information provided is true and correct. Printed Name of Owner/Agent Signature of Owner/Agent Date To be completed by certifying judge: I hereby certify that the above referenced hound passed the Qualified Courser Test by running clean with another hound of the same breed or one with a similar running style completing a course a minimum of 600 yards. Judge s Printed Name Judge s Signature Judge s Number Date 12 JERSC6 (8/09)