Premium List. Central States Collie Club Inc. (Licensed by the American Kennel Club)

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1 Premium List Central States Collie Club Inc. (Licensed by the American Kennel Club) Herding Group & Collie Obedience & Rally Each Day! Saturday February th CSCC Collie Specialty Show & Sweepstakes (morning) 90th CSCC Collie Specialty Show (afternoon) Herding Group Rally & Obedience Trials Collie only Rally & Obedience Trials Sunday February st CSCC Collie Specialty Show (morning) 92nd CSCC Collie Specialty Show (afternoon) Herding Group Rally & Obedience Trials Collie only Rally & Obedience Trials Oakview Pet Resort W. Case Rd, Wauconda IL All judging will be indoors, unbenched Show hours 7am to 7pm each day Entries close Wednesday, January 31 at 6:00 pm CST after which time entries cannot be accepted, canceled, altered or substituted except as provided for in Ch 11, Section 6 of the Dog Show Rules Show/Trial Secretary Sue Fregien, CAPER LLC Apple Rd, Waterford WI sue@caper-dogs.com Two Collie Conformation Shows Each Day! American Kennel Club Certification Permission has been granted by the American Kennel Club for the holding of this event under American Kennel Club rules and regulations. Gina M. DiNardo, Executive Secretary

2 ENTRY INFORMATION Entry fees per event: (including AKC recording/event service fees) Conformation Obedience (per trial) Rally (per trial) Regular classes $27 First entry $27 First entry $27 Puppy/Veteran classes $20 Additional entry $20 Additional entry $20 Puppy Sweepstakes $10 Brace & Veteran $20 Veteran Sweepstakes $5 Junior Showmanship $8 All entry fee checks or money orders (US funds) are to be made payable to CAPER. One check is sufficient for all enclosed entries. Entries are to be mailed to: CSCC/CAPER, Apple Rd, Waterford WI Entries must be received by 6:00 pm CST Wednesday, Wednesday January 31 after which time no entries may be accepted, cancelled, altered, or substituted. No telephone or verbal entries will be accepted. All changes and cancellations must be received in writing ( is acceptable) prior to closing, except as provided for in Chapter 11, Section 6 of the Rules Applying to Dog Shows published by the American Kennel Club. All entries must be on official AKC entry forms. Entries will be returned if they are illegible, incomplete, are submitted with incorrect fees, or are photocopied without the reverse side instructions and agreement included. Checks returned for insufficient fees will have the entry cancelled; acceptance of such an entry will only be made if the full fees, plus a $25 administrative fee, are paid via certified check or money order & received prior to the start of judging. Express deliveries must include signature waiver permitting them to be left at the Secretary s address without receipt signature. Entries received without signature release will be returned. Entries with addresses will be acknowledged with an receipt. CAPER is not responsible for non-delivery of s due to delivery errors or spam blockers, and no further efforts will be made. Confirmations and judging schedules will be sent after closing. Refunds: Entry fees will not be refunded in the event of errors or cancellation of entries after the published closing date; in the event that a dog is absent, disqualified, excused by the veterinarian or judge, or barred from competition by the Show Committee; or in the event that extreme weather conditions, riots, civil disturbances, or other acts beyond the control of the Show Committee make it impossible to open or complete the show/trial. Refunds will be made, less $5 per entry, for bitches entered in obedience or rally who come into season after the closing date, if written notice is given to the secretary at least 30 minutes prior to the start of obedience/rally classes. Fax/ entries: Entries may be faxed to the Show/Trial Secretary at , or ed to secretary@caper-dogs.com. Both the front & back of each entry form must be included, completely filled out and signed, or the entry will not be accepted. Payment can be made via PayPal or credit card by going to and following the instructions there. Payment must include the $2.00 per class additional charge to be valid. Entry Errors: Exhibitors are responsible for the correctness of entries. All entries which include an address will be sent an entry verification shortly after receipt. All errors will be corrected prior to closing; exhibitor errors discovered after closing cannot be corrected. Duplicate entries will not be refunded after closing. Overpayments of less than $5 per dog will not be refunded. Moveups to Best of Breed or Open/Master Jr Show classes: Dogs which, according to their owner s records, have completed the requirements for a championship after the closing of entries for this show may be transferred from the Dog or Bitch class to the Best of Breed class. Similarly, an entrant in a Novice Junior Showmanship can be transferred to Open if the junior has earned a third 1st place, and an Open entry can be moved to Masters if the junior has earned a tenth first place, after this show s closing date. Each of these transfer requests must be made to, and accepted by, the Show Secretary at least 30 minutes prior to the start of any regular conformation judging for the show. Saturday February 17 Collie Specialty Show, Sweepstakes, & Collie only Obedience...Event # (morning)...limited to 100 entries Collie Specialty Show (afternoon)... Event # limited to 100 entries Herding Group Rally... Event # limited to 60 entries Herding Group Obedience (excluding GSDs)...Event # Collie only Rally... Event # limited to 12 entries Ms. Lynn Hyman Butler...Ridge NY Conformation - morning show Mrs. Patricia Caldwell...Wonder Lake IL Junior Showmanship - morning show Lenore Owens... Lowell IN Sweepstakes - morning show Mrs. Joyce Beddow... Mount Airy MD Conformation & Junior Showmanship - afternoon show Ms. Loretta Lazzara... St. Charles IL Obedience & Rally (all classes) Sunday February 18 Collie Specialty Show, & Collie only Obedience...Event # (morning)...limited to 100 entries Collie Specialty Show (afternoon)... Event # limited to 100 entries Herding Group Rally... Event # limited to 60 entries Herding Group Obedience...Event # Collie only Rally... Event # limited to 12 entries Mr. Larry Willeford...Denton TX Conformation & Junior Showmanship - morning show Mrs. Mary Wells...San Martin CA Conformation & Junior Showmanship - afternoon show Mr. Fred Buroff... Plainfield IL Obedience & Rally (all classes) 2 3

3 CONFORMATION CLASSES Smooth Collies Puppy Dogs, 6 mos & under 12 mo Puppy Bitches, 6 mos & under 12 mos Bred by Exhibitor Dogs Bred by Exhibitor Bitches American Bred Dogs American Bred Bitches Open Dogs Open Bitches Veteran Dogs, 7 yrs & older Veteran Bitches, 7 yrs & older Best of Variety Rough Collies Puppy Dogs, 6 mos & under 9 mo Puppy Bitches, 6 mos & under 9 mos Puppy Dogs, 9 mos & under 12 mo Puppy Bitches, 9 mos & under 12 mos Dogs, 12 mos & under 18 mos Bitches, 12 mos & under 18 mos Bred by Exhibitor Dogs Bred by Exhibitor Bitches American Bred Dogs American Bred Bitches Open Dogs, Blue Merle Open Bitches, Blue Merle Open Dogs, Sable & White Open Bitches, Sable & White Open Dogs, Tri-Color Open Bitches, Tri-Color Open Dogs, White Open Bitches, White Veteran Dogs, 7 yrs & older Veteran Bitches, 7 yrs & older Best of Variety Best of Breed Best of Best of Winners (Saturday am show only) JUNIOR SHOWMANSHIP Novice class: For junior handlers aged 9-17 who, at the time entries close, have not won three first place awards, with competition present, in a Junior Showmanship Novice class at a licensed or member show. Open class: For junior handlers aged 9-17 who, at the time entries close, have won three first place awards, with competition present, in a Junior Showmanship Novice class at a licensed or member show. The Open class is divided (ages as of the day of the show): Master class: For junior handlers aged 9-17 who, at the time entries close, have won the 10 first place wins in an Open class with competition to be eligible to enter the Limited Class Competition. The calendar for this class will be November 1 - October 31 of the following year. All Juniors meeting the criteria for this class are required to enter the Master Class and may change their entry the day of the show if entries have already closed. Once the eligibility time frame for that year has passed all participants return to the Open Class to complete for the following year. PLEASE NOTE: Juniors must include their AKC Junior Handler number on the entry blank. Be sure all information for Junior Showmanship Classes is entered on the front and back of the entry form. Dogs shown in Junior Showmanship may have Full or Limited AKC registration or have an ILP/PAL number. Altered animals are eligible to be shown, but bitches in season are not eligible. PUPPY SWEEPSTAKES (Saturday am only) Puppy Sweepstakes is open to all Collie dogs/bitches who are at least 6 months of age and under 18 months of age on the day of the Sweepstakes. All dogs and bitches entered in Sweepstakes MUST ALSO be entered in a Regular Class at either Saturday specialty show, at the regular entry fee. Any puppy placing in sweepstakes and not shown in the Regular Classes, unless excused by the veterinarian, will be subject to forfeiture of all sweepstakes awards and prizes. Entries must be made at the same time and on the same entry form as the regular classes, indicating in the space for Additional Classes the entry in Sweepstakes. Rough and smooth coats will be combined in the classes. Puppy Dogs, 6 mos & under 9 mo Puppy Bitches, 6 mos & under 9 mos Puppy Dogs, 9 mos & under 12 mo Puppy Bitches, 9 mos & under 12 mos Dogs, 12 mos & under 18 mos Bitches, 12 mos & under 18 mos DISTRIBUTION OF SWEEPSTAKES PRIZE MONEY 25% of fees will be retained by Club for expenses. The remaining 75% (for each Sweepstakes: Puppy & Veteran) will be awarded to: Best in Sweepstakes 20% of total Sweepstakes entry Best of Opposite Sex in Sweepstakes 10% of total Sweepstakes entry Balance will be divided among the winners in each class as follows (percentages are based on entry fees for each class): First Prize-40% Second Prize- 30% Third Prize- 20% Fourth Prize- 10%. VETERAN SWEEPSTAKES (Saturday am only) Veteran Sweepstakes is open to all Collie dogs/bitches who are at least 7 years of age on the day of the Sweepstakes. Dogs and Bitches will compete together for Best in Sweepstakes. Best in Sweepstakes will receive 50% of the total entry fee and a rosette. Enter in the space for Additional Classes on the entry form. OBEDIENCE TRIALS REGULAR CLASSES OPTIONAL TITLING CLASSES NON-REGULAR CLASSES Novice A Novice B Beginner Novice A Beginner Novice B Brace Open A Open B Graduate Novice Graduate Open Veterans (8 yrs & older) Utility A Utility B Versatility If entering a class with jumps, please list the dog s jump height on the entry form. Transfers to the next higher level are allowed per the AKC rules and regulations. Entered bitches who come into season after closing are eligible to receive entry fee refunds less $5 per entry if written notice is given to the secretary at least 30 minutes prior to the start of obedience classes. RALLY TRIALS REGULAR CLASSES Novice A Advanced A Excellent A Novice B Advanced B Excellent B Intermediate Master Dogs entered in classes other than Novice must have the jump height listed on the entry form. Transfers to the next higher level are allowed per the AKC rules and regulations. Entered bitches who come into season after closing are eligible to receive entry fee refunds less $5 per entry if written notice is given to the secretary at least 30 minutes prior to the start of rally classes. 4 5

4 TROPHIES AND PRIZES This is a condensed form of Trophy list as provided for in Chapter 9, Section 2A of the AKC Rules Applying to Registration and Dog Shows. A complete list of trophies offered can be obtained by contacting Trophy Chairman Joan O Connor, 48W781 Winters Rd, Maple Park IL 60151; ; joconnor@ bittersweetfarmsporthorses.com. RIBBONS/ROSETTES Regular Classes First Prize... Blue Ribbon Best of Opposite Sex to Best of Breed...Red & White Rosette Second Prize... Red Ribbon Best of Opposite Sex to Best of Variety...Red & White Rosette Third Prize... Yellow Ribbon Select Dog/Select Bitch...Light Blue & White Ribbon Fourth Prize... White Ribbon High Scoring in Obedience Trial...Blue & Gold Rosette Winners... Purple Rosette High Combined Score in Open & Utility...Blue & Green Rosette Reserve Winners... Purple & White Rosette High Combined in Adv B/Exc B Rally...Blue & Green Rosette Best of Winners... Blue & White Rosette High Combined in Adv B/Exc B/Master...Blue & Red Rosette Best of Breed... Purple & Gold Rosette.Obedience/Rally Qualifying Score...Dark Green Ribbon Best of Variety... Purple & Gold Rosette Non-Regular Classes First Prize... Rose Ribbon Best in Sweepstakes (Puppy & Vet) Pink & Dk Green Rosette Second Prize... Brown Ribbon Best of Opp Sex to Best in Puppy Sweeps... Lavender Rosette Third Prize... Light Green Ribbon Best Junior Handler... Rose & Green Rosette Fourth Prize... Grey Ribbon Best of Best of Winners...Blue & White Rosette All trophies and awards must be claimed the day of the show, none will be mailed. Unclaimed awards will become the property of the Club. Cash prizes for sweepstakes will be presented to the handler of the dog, and neither the club nor the secretary assume any liability for cash prizes once judging has been completed. Three reasons to get your entries in early! 1) Entry fee checks are not cashed until closing 2) There is NO CHARGE to change or cancel entries before closing 3) Armband numbers are assigned randomly, not by order of entry receipt CENTRAL STATES COLLIE CLUB OFFICERS President... Laura Rizzo Vice President...Renee Beals Treasurer...Patricia Toledano Recording Secretary... Joan O Connor Corresponding Secretary... Karen Soeder 37 Spring Lane, Barrington Hills IL Board Members: Patricia Caldwell, Cindy Poturalski, Vicki Wilder SHOW COMMITTEE Patricia Toledano, Chair 41W225 Sylvan Drive, Elburn IL toledano@aol.com and the Officers & Board Members of the Club Joan O Connor, Trophy Chair SHOW OFFICIALS (all events) VETERINARIAN ON CALL Animal Emergency of McHenry County 1095 Pingree Rd, Crystal Lake IL PHOTOGRAPHER Shannon Hayes, Autumn Sun Photography 873 High Chaparral Rd, Marshall WI autumnsuncollies@gmail.com Show/Trial Secretary Sue Fregien, CAPER LLC Apple Rd, Waterford WI sue@caper-dogs.com Catalog Advertising Information Full page ad, one photo (7.5 x4.5 ) $20 Half page ad (3.5 x4.5 ) $10 Full page ad, no photo (7.5 x4.5 ) $15 Quarter page ad (1.75 x4.5 ) $5 Send your ad via to secretary@caper-dogs.com; mail check to the secretary s address. Catalog ad fees may be included with entry fees (checks made to CAPER) PDFs or JPEG files at 300 dpi work best - with any questions. Deadline is January 31 (closing date) HEALTH NOTICE: Exhibitors should follow their veterinarian s recommendation to assure their dogs are free of internal and external parasites, any communicable diseases, & have appropriate vaccinations. All persons attending this dog show hereby waive any claim for damages against the clubs or their members in the event a motor vehicle must be entered to rescue a dog from overheating or suffocation due to improper ventilation. LIABILITY: It is expressly understood that exhibitors alone are responsible for the behavior of their dogs and/or children. Any exhibitor whose dogs and/or children create unnecessary disturbances or repeatedly engage in unsafe or disruptive behavior may, at the discretion of the Show Committee, be asked to leave the show site. In such cases, no refund of any fees paid will be made. The club and its agents, employees, etc. will assume no responsibility 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. RINGSIDE: Dogs may arrive at any time prior to their scheduled time of judging. Dogs not required for further judging will be excused. Judges will not wait for any dog. Owners and agents alone are responsible for the presence of their dogs at ringside when their class is called. The club, judges, stewards and secretary have no obligation or responsibility to announce for or locate dogs that are not at ringside when required. 6 7

5 SITE INFORMATION Sweepstakes, Junior Showmanship, and Conformation classes will be held in a room off the front of the building. Obedience and Rally events will be in a separate room from conformation, with a separate entrance off the back of the building. The order of trials will be: Collie only Obedience Herding Group Obedience Collie only Rally Herding Group Rally Please turn all cell phones or pagers to Silent before entering the ring areas. Opening time of the building each morning will be posted in the judging schedule. No dogs may be left at the show site overnight. Chalking is allowed in the grooming area but you MUST use a tarp on the floor to collect all chalk. EXHIBITORS ARE RESPONSIBLE FOR CLEANING UP AFTER THEMSELVES & THEIR DOGS! Complimentary coffee and donuts will be available in the morning. Soda and water will be for sale the entire day. Lunch will be available for purchase during normal lunch times. HOTEL INFORMATION: Please be a responsible guest & use extreme caution in the treatment of motel space. Exhibitors are responsible for any damages. Please contact the hotel directly for any applicable pet fees. Holiday Inn Conference Center 800 South Rte 31, Crystal Lake IL See CSCC Facebook page for link to make reservations Candlewood Suites 1100 US 45, Libertyville IL Hampton Inn & Suites 2061 Shell Dr, Libertyville IL Comfort Inn 595 Tracy Trail, Crystal Lake IL Country Inn & Suites 600 Tracy Trail, Crystal Lake IL Super 8 Hotel Crystal Lake 577 Crystal Point Dr, Crystal Lake Super 8 Hotel Mundelein 1950 S. Lake St, Mundelein IL Baymont Inn & Suites 517 East IL 83, Mundelein IL Doubletree 510 East IL 83, Mundelein IL DIRECTIONS TO SITE From Milwaukee: I-94 south to IL Hwy 120. West on 120 to Hwy 12. South on 12 to Case Rd, turn right. Site is on the left. OR toll-free route: I-94 south to Hwy C/Wilmot Rd, west to Hwy 83, turn left. 83 into Antioch, right onto Hwy 59, continue onto Hwy 12 to Case Rd, turn right. Site is on the left. From the South/Southwest and East: I-90 to the IL-53 exit toward NW Suburbs. Follow signs for Kirchoff Rd & merge right onto IL-53 N. North 7.7 miles to Lake Cook Rd. Exit on left, go west <1 mile to Rand Rd/US-12W, turn right. Travel 12.9 miles to W Case Rd. Turn left, site is on the left. From the West: US-20 E to Marengo; left onto IL-23N/S State St. for half a mile. Right onto IL-176E/ Telegraph St.; follow IL-176 east 24 miles to N Darrell Rd, turn left. In 2.4 miles turn right onto W Case Rd. Site is on right. Health Clinic Saturday at the show site MDR1 Drug Sensitivity DNA Testing Contact Patricia Toledano at toledano@aol.com or to pre-register Italian Dinner Saturday at the show site Cost is $12 per person Contact Patricia Toledano at toledano@aol.com or to reserve your spot. Deadline is Friday February 10. We need a minimum number for dinner so please join us! 8 9

6 Conformation Sat am 2/17 Sat pm 2/17 Sun am 2/18 Sun pm 2/18 Junior Show Sat am 2/17 Sat pm 2/17 Sun am 2/18 Sun pm 2/18 Obedience Herding group Sat 2/17 Collie only Sat 2/17 Herding group Sun 2/18 Collie only Sun 2/18 Entries close at 6:00 pm CST on Wednesday, January 31. Entry fees are per show/trial. See page 2 of this premium list for entry fee information. Rally Herding group Sat 2/17 Collie only Sat 2/17 Herding group Sun 2/18 Collie only Sun 2/18 Pre-order Catalog $4 (will be $5 at show) THIS DOG S FEES ENCLOSED $ Mail entries (with fees payable to CAPER) to: CSCC/CAPER, Apple Rd, Waterford WI Express mail entries must include signature permitting them to be left at the Secretary s address without receipt signature. Any entries sent without signature release will be refused. IMPORTANT: Read instructions on the reverse side carefully before filling out. Numbers in boxes indicate sections of the instructions relevant to the information needed in that box. PLEASE PRINT! Next, be sure to read the Agreement & sign on the reverse. No form will be processed without your signature! Breed 5 Variety 1 Sex Dog Show Class 2.3 Collie OFFICIAL AMERICAN KENNEL CLUB ENTRY FORM Central States Collie Club Feb Oakview Pet Resort, Wauconda IL Additional Classes AKC Rules, Regulations, Policies and Guidelines are available on the American Kennel Club Web site, 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 person. I (WE) AGREE THAT ANY CAUSE OF ACTION, CONTROVERSY OR CLAIM ARISING OUT OF OR RELATED TO THE ENTRY, EXHIBITION OR ATTEN- DANCE AT THE EVENT BETWEEN THE AKC AND THE EVENT-GIVING CLUB (UNLESS OTHERWISE STATED IN THIS 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. Class Division 3 (Wt, color, etc) Name of (See back) Junior Handler (if any) Full Name of Dog AKC No. PAL/ILP No. Foreign Reg No. Breeder Sire Dam Actual Owner(s) 4 (Please print) Obedience Class + Jump Height Enter number here Rally Class + Jump height Date of Birth Place of Birth (list country) Junior Showmanship Class Junior Handler Number Call Name of Dog INSTRUCTIONS 1. (Variety) if you are entering a dog of 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 (longhaired, 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). 2. The following categories of dogs may be entered and shown in Best of Breed competition: Dogs that are Champions of Record and dogs which, according to their owners records, have completed the requirements for a championship, but whose championships are unconfirmed. The showing of unconfirmed Champions in Best of Breed competition is limited to a period of 90 days from the date of the show where the dog completed the requirements for a championship. 3. (Event Class) Consult the classification in this premium list. If the event class in which you are entering your dog is divided, then, in addition to designating the class, specify the particular division of the class in which you are entering your dog, i.e, age division, color division, weight division. 4. A dog must be entered in the name of the person who actually owned it at the time entries for an event 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 event 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 the AKC. (For complete rules, refer to Chapter 11, Section 3.) 5. Mixed Breed dogs entering classes for Agility, Obedience, and Rally trials should mark Breed as All-American Dog/ Mixed Breed. Sire and Dam information shall remain blank for mixed breed entrants. Owner s Address City State/Prov Zip/Postal Code Name of Owner s Agent (if any) at the Show 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,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 respresentation and Agreement. I (we) agree to conduct myself (ourselves) in accordance 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/her agent duly authorized to make this entry TELEPHONE # Are you a new exhibitor? Yes No Owner/Handler Eligible? Yes No Address (An acknowledgement or receipt of entry may be sent to this address) If this entry is for Junior Showmanhip, please provide the following information. Junior Showmanship Junior s Date of Birth AKC Junior Handler Number The above number MUST be included. Should you not have your Junior Handler number, it 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. Junior Handler s Address City State/Prov Zip/Postal Code If Junior Handler is not the owner of the dog stated on the face of this form, what is the relationship of the Junior Handler to the owner? AEN999 (11/16) v1.3 Edit

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