Great Lakes Belgian Tervuren Club Inc. (Licensed by the American Kennel Club) Rally # , Saturday # , Sunday #

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1 Premium List Great Lakes Belgian Tervuren Club Inc. (Licensed by the American Kennel Club) Rally # , Saturday # , Sunday # GREAT LAKES BELGIAN TERVUREN CLUB INC. OFFICERS President... Jacqui Fredricks Vice President... David Dachlet Treasurer... Roberta Whitesides Secretary...Sue Fregien Apple Rd Waterford WI Board of Directors: Debbie Austin, Dan DeLegge, Lynn Earhart, Shirley LaBarge, Carla Wolter SHOW COMMITTEE Lynn Earhart, Chair 403 St Lawrence Ave, Beloit WI Obedience Chair Carla Wolter Chief Ring Steward Lynn Earhart Trophies Dianne Allen Hospitality Lynn Earhart Ribbons/Rosettes Sue Fregien Eleventh Annual Independent Specialty Friday, March 9, 2018 Rally Trial Saturday, March 10, 2018 Puppy, Veteran & Working Sweepstakes Obedience Trial & Specialty Show Sunday, March 11, 2018 Obedience Trial & Specialty Show Rock County Fairgrounds 1301 Craig Ave, Janesville WI All judging will be indoors, unbenched Show hours 2pm to 8pm Fri, 7am to 5pm Sat/Sun Entries close Wednesday, February 21 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 Anne Heyrman, c/o CAPER LLC Apple Rd, Waterford WI secretary@caper-dogs.com 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 VETERINARIAN ON CALL Animal Emergency Clinic 3113 McCormick Dr, Janesville WI PHOTOGRAPHER Vicki DeGruy, DeGruy Photography 9828 E. Cty Rd A, Janesville WI Proofs will be posted on online at No proofs will be mailed. PLEASE NOTE! Candid photography at this event will be for personal use only it shall not be put up for retail sale. JUDGES Mr. Fred Buroff... Plainfield IL Rally & Obedience, all classes Mr. James Moses...Wentzville MO Saturday Conformation Ms. Susan Manier...Batavia IL Sweepstakes Mrs. Danelle Brown...Georgetown TX Sunday Conformation and Junior Showmanship 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

2 ENTRY INFORMATION Entry fees per day: (including AKC recording/event service fees) Conformation/Obedience Rally First entry $26 First entry $26 Additional entry $19 Add l entry $19 Puppy (6-9, 9-12) & Veteran $19 Obedience Veteran/Brace $19 Junior Showmanship $10 Sweepstakes (Sat only) $10 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: CAPER/GLBTC, Apple Rd, Waterford WI Entries must be received by 6:00 pm Wednesday, February 22 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 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. Site Information Setup of equipment will be permitted Friday March 9 at 2pm. The building will be available at 6:30am Saturday & Sunday. No dogs are allowed in the building overnight. Overnight parking is not allowed. Breakfast & lunch will be available on site, provided by the Rock County 4-H Dog Project. Please turn pagers and cell phones to Silent mode when entering the ring area. EXHIBITORS ARE RESPONSIBLE FOR CLEANING UP AFTER THEMSELVES & THEIR DOGS! TROPHIES AND PRIZES The following trophies will be offered by the Great Lakes Belgian Tervuren Club, and/or trophy sponsors. Trophy sponsorships are being sought for all trophies for the weekend. If you are interested in sponsoring a trophy, please contact the Trophy Chair, Dianne Allen, at tervuren200@aol.com or Wood-burned etched trophies will be offered for the following: Friday Highest CombinedScore in Advanced B/Excellent B Highest CombinedScore in Advanced B/Excellent B/Master Saturday Best in Puppy Sweepstakes & Best of Opposite Sex in Puppy Sweepstakes Best in Veteran Sweepstakes & Best of Opposite Sex in Veteran Sweepstakes Best in Working Sweepstakes & Best of Opposite Sex in Working Sweepstakes Saturday & Sunday Best of Breed Best of Opposite Sex Best of Winners Winners Dog & Winners Bitch Reserve Winners Dog & Reserve Winners Bitch Best Junior Handler First Place in all conformation & obedience classes Highest Scoring Dog in Regular Obedience Classes Highest CombinedScore in OpenB/Utility Tervuren Notecards will be offered for: First Fourth Places in Sweepstakes classes Inflator milker toys will be offered for: First Fourth Places in all Rally, Obedience and Conformation classes RIBBONS/ROSETTES Regular Classes First Prize... Blue Ribbon or Rosette Best of Breed...Purple & Gold Rosette Second Prize... Red Ribbon Best of Opp Sex to Best of Breed...Red & White Rosette Third Prize...Yellow Ribbon Select Dog/Bitch...Light Blue & White Rosette Fourth Prize...White Ribbon High Scoring in Reg Obedience...Blue & Gold Rosette Winners...Purple Rosette High Combined in OpenB/Utility...Blue & Green Rosette Reserve Winners...Purple & White Rosette High Combined in AdvB/ExcB...Blue & Green Rosette Best of Winners... Blue & White Rosette High Combined in AdvB/ExcB/Mstr... Blue & Red Rosette Obedience/Rally Qualifying Score...Dark Green Ribbon Non-Regular Classes First Prize...Rose Ribbon or Rosette Best in Sweepstakes...Pink/Dark Green Rosette Second Prize...Brown Ribbon Best of Opp Sex in Sweepstakes...Lavender Rosette Third Prize... Light Green Ribbon Best Junior Handler... Rose & Green Rosette Fourth Prize... Grey Ribbon Award of Merit... Green 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.

3 CONFORMATION CLASSES Regular Classes Puppy Dogs, 6 mos & under 9 mos Puppy Bitches, 6 mos & under 9 mos Puppy Dogs, 9 mos & under 12 mos Puppy Bitches, 9 mos & under 12 mos Dogs, 12 mos & under 18 mos Bitches, 12 mos & under 18 mos Amateur Owner Handler Dogs Amateur Owner Handler Bitches Bred by Exhibitor Dogs Bred by Exhibitor Bitches American Bred Dogs American Bred Bitches Open Dogs Open Bitches Best of Breed Non-Regular Classes Veteran Dogs Veteran Bitches Open to dogs/bitches 8 yrs & older; may be altered. Winners eligible to compete in Best of Breed. Herding Titled Dogs Herding Titled Bitches Open to unaltered dogs/bitches with any AKC herding title. Winners eligible to compete in Best of Breed. PUPPY SWEEPSTAKES Puppy Sweepstakes is open to all AKC registered Belgian Tervuren who are at least 6 months of age and under 18 months of age on the day of the Sweepstakes. Entrants do not need to be entered in a regular class. Champions of Record may compete. Puppy Dogs, 6 mos & under 9 mos Puppy Bitches, 6 mos & under 9 mos Puppy Dogs, 9 mos & under 12 mos Puppy Bitches, 9 mos & under 12 mos Dogs, 12 mos & under 18 mos Bitches, 12 mos & under 18 mos VETERAN SWEEPSTAKES Veteran Sweepstakes is open to all AKC registered Belgian Tervuren who are at least 8 years of age on the day of the Sweepstakes. Entrants do not need to be entered in a regular class, and may be altered. Champions of Record may compete. Dogs, 8 yrs & under 10 yrs Bitches, 8 yrs & under 10 yrs Dogs, 10 yrs & under 12 yrs Bitches, 10 yrs & under 12 yrs Dogs, 12 years & over Bitches, 12 years & over WORKING SWEEPSTAKES Working Sweepstakes is open to all AKC registered Belgian Tervuren who fulfill the title requirements of the classes as listed. Entrants do not need to be entered in a regular class, and may be altered. Champions of Record may compete. Classes will be divided by sex. Each class requires titles in at least two areas of AKC competition (agility, herding, obedience, tracking), one of which is at a level higher than the entry level title. Entry level Working 1 Working 2 Working CH CD CDX UD/UDX OTCH NA/NAJ/NAP/NJP AX or AXJ MX or MXJ MACH or PACH OA/OAJ/OAP/OJP AXP or AJP MXP or MJP HS HI HX HC TD/TDU TDX or VST CT Examples: CDX TD or CD AX is Working 1. UDT or CD HX is Working 2. MACH HS is Working CH. DISTRIBUTION OF SWEEPSTAKES PRIZE MONEY No entry money will be retained by Club. The Sweepstakes entry money (for each Sweepstakes: Puppy, Veteran, & Working) will be divided as follows: Best in Sweepstakes Best of Opposite Sex in Sweepstakes First place each class Second place each class 30% of total Sweepstakes entry 20% of total Sweepstakes entry 30% of entry fees for the class 20% of entry fees for the class JUNIOR SHOWMANSHIP (Sunday only) 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. 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. RALLY TRIAL (Friday only) REGULAR CLASSES Novice A Advanced A Excellent A Intermediate Novice B Advanced B Excellent B Master OBEDIENCE TRIALS (Saturday & Sunday) REGULAR CLASSES Novice A Open A Utility A Novice B Open B Utility B OPTIONAL TITLING CLASSES Beginner Novice A Graduate Novice Preferred Novice Beginner Novice B Graduate Open Preferred Open Versatility Preferred Utility NON-REGULAR NON-TITLING CLASSES Veterans (dogs 8 yrs & older, not entered in regular obedience class) Brace OBEDIENCE ENTRANTS: Please enter your dog s jump height (if applicable) on the entry form. Transfers to the next higher level in both obedience and rally are allowed per AKC rules and regulations. Bitches entered in obedience or rally who come into season after closing will receive a full entry fee refund if written notice is given to the secretary at least 30 minutes prior to the start of judging for that day. 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. CATALOGS: Catalogs are $4 each if pre-ordered on entry form. A limited number of catalogs will be available during the show for $5 each.

4 SPECIAL EVENTS Friday March 9 Eye Clinic Dr. Keith Collins will be performing OFA eye exams from about 5-8pm on Friday. Cost is $40/dog for GLBTC members and $45/dog for non-members. Open to all breeds. See form below to sign up and reserve exam times. Limited to 40 dogs. Walk-ups available if space permits. ***You MUST have the dog s AKC registration number for the exam!!! Canine Good Citizen (CGC) Test 3pm Friday, 10 dog limit, open to all breeds/mixes Free to GLBTC members, $15/dog to non-members (pay at test) Reserve spots by ing Sue Fregien at sue@tervolk.com Saturday March 10 GLBTC Annual Meeting The 2018 GLBTC Annual Meeting will begin shortly after the completion of judging. All members are encouraged to attend. Club Banquet Join us for a GLBTC-sponsored banquet right at the show site! Start time approx 5:30pm. $10 for GLBTC members, $20/person for non-members See form below to reserve space/make payment - due no later than March 1. HOTEL INFORMATION: Exhibitors must contact motels directly and identify themselves as having dogs. Some require deposits or fees per dog per night. Please use extreme caution in the treatment of motel space. PLEASE be a responsible motel guest. All hotels are in Janesville WI EconoLodge 3520 Milton Ave America s Best Value Inn 3900 Milton Ave Motel Milton Ave or Baymont Inn 616 Midland Rd or BUDGET Microtel Inn 3121 Wellington Place or DIRECTIONS TO SITE The Rock County Fairgrounds are located at the corner of Randall Ave and Craig St (1301 Craig St). From the north: I-90 exit 171A, Hwy 26 (Milton Ave) into Janesville, turn left onto Mt. Zion Ave. Turn right on Randall Ave. Turn right on Craig Ave and go ~1 block to the fairground entry gate. From the south: I-90 exit 175 A, Business Hwy 14 (Racine St) into Janesville. Turn right onto Randall Ave. Turn left onto Craig Ave and go ~1 block to the fairground entry gate. NO FIREARMS ALLOWED ON THE SITE. Silent Auction to benefit ABTC Rescue GLBTC will be holding the silent auction of dog-related items to benefit the American Belgian Tervuren Club s Rescue program. Please support the auction by donating a dog-related item. Contact Roberta Whitesides for more information or mxterv@aol.com Catalog Advertising Full page ad (7.5 x4.5 ) $15 Half page ad (3.75 x4.5 ) w/ photo $10, no photo $5 Ads/payment (payable to CAPER) sent to Show Secretary (address on page 2). Ad fees may be combined on the same check with entry fees. Ad submission deadline February 21 (closing date of show). Reservation form for Eye Clinic and Saturday Club Banquet Name Phone # dogs for Eye Clinic $40/dog GLBTC members, $45/dog non-glbtc members Banquet reservations (deadline March 1) # GLBTC Members $10 each # Non-members $20 each Send form & payment (payable to GLBTC) to Lynn Earhart/GLBTC 403 St. Lawrence Ave Beloit WI Questions: or magical@ticon.net

5 Fri 3/9 Rally Pre-order Catalog $4.00 OFFICIAL AMERICAN KENNEL CLUB ENTRY FORM Great Lakes Belgian Tervuren Club Inc. March Rock Cty Fairgrnds, Janesville WI Conformation Sat 3/10 Junior Show Obedience Sat 3/10 Entries close at 6:00 pm CST on Wednesday, February 21. Entry fee information is on page 2 of this premium. This dog s fee enclosed $ ***Fax/ entries accepted - see page 2 for instructions. Mail entries (with fees payable to CAPER) to CAPER/GLBTC, 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 Belgian Tervuren Dog Show Class 2.3 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

Name: Dog & Class Entered: Dog & Class Entered: Dog & Class Entered: Zip Code: CC Type: CC Number:

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