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Shiba only on Friday (plus obedience and rally for shiba s only ) All Breed Agility Sat/Sun W Springfield, PA 16443 4651 Nye RD Shelley Stemple Countryside Agility Event # 2005237606 Event #

1 Shiba only on Friday (plus obedience and rally for shiba s only ) All Breed Agility Sat/Sun W Springfield, PA Nye RD Shelley Stemple Countryside Agility Event # Event # Event # Premium List 1 Specialty and 2 AKC All-Breed Agility Trials (Licensed by the American Kennel Club September Countryside Agility Training Center 220 W Plum Suite 600 St Edinboro Pa FRIDAY is Shiba only!! Trial hours daily 7 am to 7: pm Judging will begin at noon on Friday and 8:00am Sat/Sun Judge: Denise Thomas (fri) Cynthia Tilly (sat/sun) entries are LIMITED to 330 runs per day. Entries will be taken by Random Draw method Draw Opening Date: 7/6/05 at 8 am Draw Close 7/18/05 6pm.. Draw will be on 7/19/05 at 10 am. Draw will be held at the residence of Shelley Stemple 4651 Nye Rd W Springfield PA 16443

2 All titling classes offered in Standard and JWW (including preferred) AMERICAN KENNEL CLUB CERTIFICATION Permission has been granted by the American Kennel Club for the holding of this event under AKC Rules and Regulations. James P. Crowley, Secretary Mail all entries with fees (checks or money orders only) payable to : Shelley Stemple 4651 Nye Rd W Springfield PA (814) Countrysideas3@aol.com Entry fees per dog per day: (includes $3 AKC recording fee) $20 First entry $12 Second entry (same dog) each day As this trial is limited, you may contact me by to see if you got in. Please include on entry so I may contact you, if needed. Entries close on 9/6/05 at 6 PM. Entry form changes, additions, corrections, and cancellations MUST be received in writing by Monday Sept 19 th at 6 PM. No telephone changes accepted. Day to day move-ups will be accepted. Ring will be 85x100 on ½ matting with ring gating Electronic timing will be used President: Jacey Holden 3991 W Peltier Rd, Lodi, CA Vice-Pres Mary Ross 2444 Somerset Drive, New Orleans, LA Secretary: Barbara Molands 700 Old Memorial Drive Sandston, VA Treasurer: Tisha Harris 9975 Madison Twp Rd #57 Roseville,OH Trial Committee Chairperson: Norma Hornung 230 Falls Village Rd Pittsburgh, PA pepperpaws@alltel.net Members: Norma Hornung, Joanne Takata, Joan Althouse, Karen Groth, Mark Giles, Eunice Giles Trial Secretary Shelley Stemple 4651 Nye Rd W. Springfield, PA (814) , CountrysideAS3@aol.com Veterinarian on Call Pet Emergency Center (814) W 38th St Erie PA Trial Judge Denise Thomas PO Box 526 Fairview PA Cynthia Tilly 528 Pershing Hwy Sunset LA Exhibitors should follow their vet s recommendations to assure their dogs are free of internal and external parasites, any communicable diseases, and have appropriate vaccinations." Volunteer to Work! If you are able to help out at the Shiba show, please volunteer to work. Our club is small and helpers are always appreciated. If you are able to help, please fill out the form below and include it with your entry! Name: I am able to help: Friday Saturday Sunday I can do the following: Bar Setting Asst Scribe Scribing Timing Gate Keeper Leash /ScribeRunner Course Build Chute Class my dog is running in: Dog Class Height: Phone:

3 Agility Trial Move-Up Use this form to move up to a higher agility class only Sept 23-25, 2005 Breed: Sex: Move Entry to: (Please circle) Std Class: Open Excellent A Excellent B JWW: Open Excellent A Excellent B Jump height Division: Days dog is entered : Fri Sat Sun Dog s AKC Registered Name: AKC Reg. No.: ILP No.: Foreign Reg. No.: Dog s Call Name: Owner s Name: Handler s Name: Signature of owner or agent duly authorized to make this entry: Signature of Trial Secretary: Approved: YES NO Date: Prizes and Awards Rosettes and a stuffed toy will be awarded to the first through fourth place dogs in each Class and height division. Flat qualifying ribbons will be awarded to all dogs receiving qualifying scores. Special ribbons will be given to all Double Q s in the Excellent B class All prizes require a qualifying score. New Title Ribbons will be awarded to those earning a title at the show. HIT Standard FRI - Rosette and glass vase etched with a Shiba design HIT JWW FRI - Rosette and glass vase etched with a Shiba design A special MACH ribbon and MACH bar will be awarded to any dog earning a MACH at this trial. Judging Friday Saturday Sunday Schedule Shiba Only ALL Classes Denise Thomas Cynthia Tilly Cynthia Tilly Red Roof Inn I90 Exit 27 (17 min) Motel 6 I90 Exit 24 (15 min) Comfort Inn Erie I90 Exit 24 (15 min) Edinboro Inn Edinboro, Pa (2 min) Camping on site Hotel Information 7865 Perry Highway Erie PA Peach St Erie PA Peach St Erie PA 16509) West Plum St Edinboro PA Camping available in parking lot no charge Directions to Show site (Edinboro, Pa is just south of Erie. Lakeside Commons is an old mall located right on Lake Edinboro) From South Take I79 north to Exit #166 (Edinboro Rt 6N) turn right (east ) and go 2.17 miles to Lakeside Commons (on left ).Entrance is just after the cement bridge, if you get to Taco Bell you have missed entrance. Training center is all the way around back of the building right on the lake, Suite 600. Countryside Agility Signs in window unloading for crating will be marked. Please do not enter with dogs at front of mall! From East and West - Take I90 East or West to Rt 79 South. Get off at Exit 166 (Edinboro Rt 6N) and turn left (east) and go 2.17 miles to Lakeside Commons on left.

4 Course Familiarization THERE WILL BE NO NOVICE CONTACT OBSTACLE FAMILIARIZATION AT THIS TRIAL Height Divisions Owners are responsible for entering the proper height divisions All dogs except those jumping 24 will be measured if a height card is not shown in advance or day of trial.( If a rep or VMO is present then ALL 24 dogs must be measured as well). Regular class Preferred class 8 inches... For dogs 10 inches and under at the withers inches...for dogs 14 inches and under at the withers inches...for dogs 18 inches and under at the withers inches...for dogs 22 inches and under at the withers inches... For dogs over 22 inches at the withers 20 See complete rules in the Regulations for Agility Trials available at Move Up Regulations If a dog earns an agility title before this event, it can be advanced to the next level of competition. However, written notice MUST be given to Trial Secretary no later than 12 PM on Mon Sept Move-ups will be accommodated from day to day at the trial. No verbal changes will be accepted. Refunds No entry fees will be refunded if the trial cannot open or be completed by reason of riots, civil disturbances, fire, an act of God, public emergency, act of a public enemy, or any other causes beyond the control of the organizing committee. Entry fees shall not be refunded in the event that a dog is absent, disqualified, excused by a veterinarian or judge, or barred from competition by action of the Trial Committee. Bitches in season will be awarded a refund (with a Veterinary Certificate), less $10 processing fee per day. Camping: Camping is permitted on the grounds Liability It is expressly understood that exhibitors alone are responsible for the behavior of their dogs and/or children. Any exhibitor whose dog and/or children create unnecessary disturbances or repeatedly engage in unsafe or disruptive behavior may, at the discretion of the Trial committee, be asked to leave the show site. In such cases, no refund of any fees paid will be made. Countryside Agility, National Shiba Club and its agents, employees, etc. will assume no responsibilities for any loss, damage or injury sustained by exhibitors or handlers, or to any of their dogs or property, & further assume no responsibility for injury to children Food will be sold on site sat and sun and there are fast food and other restaurants within walking distance.

5 Official American Kennel Club Entry Form September th 2005 Friday Sept 23rd Standard SHIBA ONLY!!!! Friday Sept 23rd JWW Saturday Sept 24h Standard all breed Saturday Sept 24th JWW Sunday Sept 25th Standard all breed Sunday Sept 25th JWW ENTRY FEE: (Including $3.00 AKC recording fee) is $20.00 for each dog entered in first run and $12.00 for same dog entered in second run. Trial closes on 9/6/05 at 6 PM. Make checks payable in US Funds to: NSCA, and mail to: Shelley Stemple 4651 Nye Rd W Springfield PA ***** Express mail entries must include signature ***** PLEASE PRINT Incomplete or illegible entries will be returned. (IMPORTANT: CAREFULLY READ INSTRUCTIONS ON REVERSE SIDE BEFORE FILLING OUT) BREED VARIETY SEX HEIGHT AT WITHERS STANDARD AGILITY CLASS (circle one) JUMPERS WITH weaves (circle one) JUMP HEIGHT (circle one) NOV A NOV B OPEN EX A EX B NOV A NOV B OPEN EX A EX B PREFERRED AGILITY CLASS (circle one) PREFERRED JWW (circle one) JUMP HEIGHT (circle one) NOVICE OPEN EX A EX B NOVICE OPEN EX A EX B NON-REGULAR AGILITY CLASSES: INTERNATIONAL SWEEPSTAKES CLASS JUMP height (circle one) (if offered) STD JWW (circle one) AKC REGISTERED NAME (Include AKC titles only) AKC REG. NO. (Enter number here) AKC LITTER NO. ILP NO. DATE OF BIRTH PLACE OF BIRTH CALL NAME OF DOG FOREIGN REG. NO. & COUNTRY USA CANADA FOREIGN BREEDER SIRE DAM ACTUAL OWNERS OWNERS ADDRESS NEW ADDRESS CITY, STATE, ZIP + 4HANDLER (Junior Handler see back) FEE ENCLOSED 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 by any additional rules and regulations appearing in the premium list for this event, and further agree to be bound by the "Agreement" printed on the reverse side of this entry form. I (we) certify and represent that the dog entered is not a hazard to persons or other dogs. This entry is submitted for acceptance on the foregoing representation and Agreement. I (we) agree to conduct Rules, Regulations, Policies and Guidelines are available on the American Kennel Club Web site, with all such Rules and Regulations (including all provisions applying to discipline) and to abide by any decisions made in accord with them. Signature of owner or his agent duly authorized to make this entry telephone AGREEMENT 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 liability 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 therefrom, 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 EVENT-GIVING CLUB (UNLESS OTHERWISE STATED IN ITS 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. INSTRUCTIONS (Variety) If you are entering a dog of a breed in which there are varieties for show purposes, please designate the particular variety you are entering, i.e. Cocker Spaniel (solid color black, ASCOB, parti-color), Beagles (not exceeding 13 in., over 13 in. but not exceeding 15 in.), Dachshunds (long-haired, smooth, wirehaired), Collies (rough, smooth), Bull Terriers (colored, white), Manchester Terriers (standard, toy), Chihuahuas (smooth coat, long coat), English Toy Spaniels (King Charles and Ruby, Blenheim and Prince Charles), Poodles (toy, miniature, standard). A dog must be entered in the name of the person who actually owned it at the time entries for a trial closed. If a registered dog has been acquired by a new owner, it must be entered in the name of its new owner in any trial for which entries closed after the date of acquirement, regardless of whether the new owner has received the registration certificate indicating that the dog is recorded in his/her name. State on entry form whether transfer application has been mailed to AKC. (For complete rules, refer to Chapter 11, Section 3.) If this entry is for Junior Showmanship, please give the following information: JUNIOR SHOWMANSHIP JR. S DATE OF BIRTH AKC JUNIOR HANDLER NUMBER The above number MUST be included. Should you not have your Junior Handler number, this may be obtained from the American Kennel Club. Phone: (919) By signing the entry form I (we) certify that the Junior Showman does not now, and will not at any time, act as an agent/handler for pay while continuing to compete in Junior Showmanship. ADDRESS CITY STATE ZIP If Junior Handler is not the owner of the dog identified on the face of this form, what is the relationship of the Junior Handler to the Owner? AEAGL2(4/04-1)

AMERICAN KENNEL CLUB CERTIFICATION

AMERICAN KENNEL CLUB CERTIFICATION Shiba only on Friday (plus obedience and rally for shiba s only ) All Breed Agility Sat/Sun W Springfield, PA 16443 4651 Nye RD Shelley Stemple Countryside Agility Event # 2006237606 Event # 2006237605