February 3, 2017 ENTRY LIMITED TO 4 1/2 HOURS of JUDGING Waitlist will be kept until closing.

Transcription

1 ENTRY METHOD: FIRST RECEIVED ENTRIES WILL OPEN ON December 7, PST at the Trial Secretary s address. All entries received before this date will be returned. Overnight or certified mail must be sent with the No Signature Required waiver signed. ENTRIES CLOSE ON January 20, 6:00 p.m. PST after which time entries cannot be accepted, cancelled, altered, or substituted EXCEPT as provided for in Ch. 11, Sec. 6 of the Dog Show Rules or Ch. 1, Sec. 16 of the Obedience Regulations. Envelopes/transactions containing entries for more than the ten (10) dog maximum and/or entries received prior to the opening date shall be treated as an invalid entry and shall be returned to the sender. PREMIUM LIST AKC All-Breed Obedience & Rally Trial This Event is Accepting Entries for Mixed Breed Dogs Listed in the AKC Canine Partners Program SM Mt Hood Doberman Pinscher Club (Licensed by the American Kennel Club) February 3, 2017 ENTRY LIMITED TO 4 1/2 HOURS of JUDGING Waitlist will be kept until closing. Clark County Fairgrounds NE Delfel Road Ridgefield, WA Indoors on Packed Dirt: Size of Ring(s): 40x50 Trial Hours: Friday 7:00am to 6:00pm Rally/Obedience Judging Hours 7:30 am to 12:00 pm Judges: Karla Curtis, Salem OR Curt Curtis, Salem OR CERTIFICATION Permission is granted by the American Kennel Club for the holding of this event under American Kennel Club rules and regulations. Event # /06 James P. Crowley, Secretary

2 OFFICERS OF THE MT HOOD DOBERMAN PINCHER CLUB President: Dawn Danner SW Barberry Dr., Beaverton, OR Vice-President: Gail Veterino PO Box 80591, Portland, OR Treasurer: Ellen Hanley S. Needy Road, Woodburn, OR Secretary: Donna Kemp 1197 Glazemeadow St. N., Keizer, OR EVENT COMMITTEE Kathy Koren, Nancy Thorson, Linda Zaeske, Mike Dellorto, Paula Ratoza, Karen Langlois, All Board Members and Club Members present TRIAL CHAIRPERSON Paula Ratoza 3544 NE 120th Ave Portland, OR (503) TRIAL SECRETARY Karen Langlois 134 Daves View Drive Kalama, WA (503) Karla Curtis # Bates Rd, S. Salem OR JUDGES & ASSIGNMENTS Curt Curtis # Bates Rd, S. Salem OR RALLY NOVICE A RALLY NOVICE B BEGINNER NOVICE A BEGINNER NOVICE B NOVICE CLASS A NOVICE CLASS B Judging is LIMTED to 4 1/2 HOURS for each judge. Judging will begin at 7:30 am in both rings as we need to have the trial completed by noon. VETERINARIAN OPEN CLASS A OPEN CLASS B UTILITY CLASS A UTILITY CLASS B RALLY ADVANCED A RALLY ADVANCED B RALLY EXCELLENT A RALLY EXCELLENT B Columbia River Veterinary Specialists (24H), 6818 STE C NE Fourth Plain Blvd., Vancouver, WA, 98661, (360) I-5 South to 205-South. Take Exit 32 for Padden Pkwy. Right at NE Padden Pkwy, Left at NE Andresen Rd, Right at NE 4th Plain Blvd DOG ELIGIBLE TO ENTER This trial is open to all dogs six (6) months of age or older that are registered with the American Kennel Club or that have AKC Limited Registration, Purebred Alternative Listing/Indefinite Listing Privileges (PAL/ILP), an AKC Canine Partners listing number, or approved Foundation Stock Service (FSS) breeds are eligible to participate. Dogs with a Purebred Alternative Listing/Indefinite Listing Privileges (PAL/ILP) or an AKC Canine Partners listing number must be spayed or neutered in order to compete. Wherever the word dog is used in these regulations it includes both sexes.

3 OBSTACLES AND RING CONDITIONS Obstacles will meet the specifications for obstacles in the current edition of the Regulations for Agility Trials. All classes will take place indoors on a packed dirt surface. Size of Ring(s): 40x50 ENTRY FEES PER DAY Per Dog, Per Event Per Trial Includes AKC Fees where applicable OBEDIENCE TRIAL First Entry in the Obedience Trial... $22.00 Each additional entry for the same dog in same Obedience Trial... $20.00 RALLY TRIAL First Entry in the Rally Trial... $22.00 Each additional entry for the same dog in same Rally Trial... $20.00 MAKE ALL CHECKS AND MONEY ORDERS payable to: MHDPC MAKE ALL CANADIAN checks and money orders payable in U.S. funds. MAIL ENTRIES WITH FEES: Karen Langlois, 134 Daves View Dr, Kalama, WA REFUNDS For cancellations due to judge change or cancellations made prior to entries closing will be mailed by the Club to said Exhibitor or Agent AFTER THE SHOW. An administrative fee of $5.00 will be withheld from all refunds for entries cancelled prior to the closing of entries ir for bitches that come into season if a vet s letter is provided. No entry fee 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 cause beyond the control of the organizing committee. No entry fee will be refunded in the event a dog is absent, disqualified, excused, or barred from competition by the action of the Trial Committee OBEDIENCE & RALLY TRIAL TRANSFERES Transfers/move-ups will be allowed at this trial. The following criteria apply: *You may move from an obedience class to an obedience class; or from a rally class to a rally class. You may move from an A to a B class at the same level (i.e.: Novice A to Novice B). The class must be offered at this trial and the judge must not have already reached his/her limit. *The request for a transfer/move-up must be in writing and presented to the superintendent or trial secretary at least 30 minutes prior to the start of the trial day at 8 am. You may your request to Theresa@K9EventsNW.com until noon January 30. *You also have until 30 minutes prior to the start of the trial day at 7am to submit any corrections regarding incorrect entry level as long as the request is in writing and accompanied by your AKC notification letter. You may your request to Theresa@K9EventsNW.com until noon January 30. RIBBONS, AWARDS, AND PRIZES Ribbons will be awarded in each obedience and rally class as follows: First Place Blue Second Place..... Red Third Place..... Yellow Fourth Place..... White Qualifying Score Dark Green

4 High in Trial-Obedience, High in Trial-Rally, High Combined-Obedience (Utility B & Open B) and High Combined-Rally (Advanced B and Excellent B) will each receive a certificate for up to $25 towards entry fees for a future MHDPC Agility, Obedience, or Rally trial. High in Trial-Obedience Doberman Pinscher and High in Trial-Rally Doberman Pincher will each receive a Doberman Pincher themed item. NOTICE TO EXHIBITORS The American Kennel Club Rules and Regulations will govern this Show and Exhibitors must make themselves familiar with the agreement of the American Kennel Club, referred to on the reverse side of the entry blanks that accompany this Show Premium List. All exhibitors should obtain a copy of the AKC Obedience Regulations and Rally Regulations by downloading them from the American Kennel Club website The American Kennel Club (AKC)will collect: a $3.00 Event Service Fee and $.50 Recording Fee where applicable for the first entry of a dog, plus a $3.00 service fee for each additional entry of the same dog in the regular and non-regular recordable single-entry classes. At every licensed or member club rally trial, a recording fee of $3.50 is required for the first entry of each dog and a recording fee of $3.00 is required for each additional entry of the same dog. The event-giving club shall assume the responsibility of collecting all Event Service Fees for the AKC. These event service and recording fees shall be forwarded to AKC along with all other required event results within seven days of the close of the event. No Entry will be accepted which specifies any condition as to its acceptance. and unsigned entries cannot be accepted and will be returned. Entries not on Official AKC Entry Forms and Photocopies of Entry Forms without Agreement and Rules on reverse side are NOT ACCEPTABLE. The Club and/or K9EventsNW assumes no responsibility for wrong or incomplete information given on the entry blank by the owner or the owner s agent. RESPONSIBILITY FOR COMPLETENESS OF ENTRY RESTS SOLELY WITH ENTRANT. RETURNED CHECKS DO NOT CONSTITUTE A VALID ENTRY FEE. The Club will add a $30.00 collection fee to the amount of each returned check. We will not re-process checks. The exhibitor will be contacted & required to send a money order for the original amount PLUS the $30.00 NSF fee. Subsequent returned checks from same person may result in their being put on a CASH ONLY BASIS. NO FAX ENTRIES will be accepted for this event. Entries will be acknowledged via after entries close with entry acknowledgment and judging program to the or postal address on entry. Should Exhibitor NOT receive an acknowledgment within 5 days of the trial closing, PLEASE notify K9EventsNW at (206) or Theresa@K9EventsNW.com Entry fees shall NOT be refunded in the event that a dog is absent, disqualified, sick, lame, excused by the Judge or Veterinarian, or barred from competition by action of the Show Committee, or because it has been entered incorrectly. There is no refund for DUPLICATE ENTRIES or OVERPAYMENTS. K9EventsNW will make every effort to find all duplicate entries, but if entry has been processed, no refund will be made. If, because of riots, civil disturbances or other acts beyond the control of the management it is impossible to open, or to complete the Show NO REFUND will be made. To find out about any AKC event cancellations call the AKC Event Cancellation Hotline Dogs need be present only for scheduled judging and will be released if not needed for further judging. Dogs must be ready for judging. Judges need not wait for any dog holding up a class. Owners or agents alone are responsible for the presence of their dogs in the judging rings. Only dogs eligible for these shows will be admitted into the show area. There is no provision for unentered dogs. SAFETY, BEHAVIOR, LIABILITY, & OTHER TOPICS *The safety of the dog is our primary concern. By entering this trial, exhibitors acknowledge that they are familiar with the rules and regulations of this sport, and that their dogs are familiar with and able to perform all obstacles safely. *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 an unnecessary disturbance 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 case, no refund of any fees paid will be made. The Mt Hood Doberman Pincher Club (MHDPC) and its agents/employees, will assume no responsibilities for any loss, damage or injury sustained by exhibitors or handlers, or to any of their dogs or property and further assumes no responsibility for injury to children. The MHDPC reserves the right to decline entries for cause and may remove any dog for aggression. No one shall have any recourse or claim against the MHDPC or any official thereof. *All dogs must be on leash at all times when on trial grounds except when in the designated warm-up area or competing on the course. *Judges are not required to wait for dogs. The Owner of each dog is solely responsible for having it ready at ringside when it is to be judged. The Club has no responsibility for providing service through a public address system or stewards or runners for the purpose of calling or locating dogs that are not brought into the ring when required.

5 *Advance catalog sales may be ordered and prepaid on your entry form for $15 A limited number of catalogs will be available for sale at the trial site for a cost of $15 *This club does not agree to arbitrate claims as set forth on the Official AKC Entry Form for this event AGILITY TRIAL INFORMATION The club is also holding its agility trial at this venue following the obedience trial. The trial is Friday, 2/3, Saturday, 2/4, & Sunday, 2/5. Friday is all levels of STD, JWW & T2B; Saturday is all levels STD, JWW, FAST, & T2B; Sunday is all levels of STD, JWW &T2B. All Breed including AKC Canine Partners. Judges are Victoria MacVicar and Lori Sage. Your agility trial secretary is Robin Cohen. You may contact her at r2agility@frontier.com or (425) Visit for more information about the trial. DIRECTIONS TO CLARK COUNTY FAIRGROUNDS NE Delfel Road, Ridgefield, WA Take I-5, Exit #9 (in Washington), head west on 179th for ½ mile, turn left HOTEL INFORMATION These hotels have graciously agreed to accept our well-mannered dogs. A pet deposit may be required. Please check with hotels for policies and restrictions. La Quinta Inn & Suites 1500 NE 134th Street, Vancouver, WA Shilo Inn 401 E 13th Street, Vancouver, WA, Red Lion Salmon Creek, 1500 NE 134th Street, Vancouver, WA, Comfort Inn NE 20th Avenue, Vancouver, WA, Ferryman s Inn 7901 NE 6th Avenue, Vancouver, WA, Overnight Parking Overnight RV parking spots will be available at the trial site. All spots will be available on a first come, first served basis. Reservations and payment must be made in advance. All spots will be confirmed prior to the show. Parking/camping (with or without electrical hook-up) $20.00/night RV Spaces will not be finalized before 5:00 on Thursday. If you set-up before 5:00, MHDPC may ask you to move from a space or hookup. RV Camping Form Make checks payable to MHDPC Return completed form and camping check to the trial secretary. Please include a separate check for camping fees Name: RV Type: Motorhome _ Trailer _ Length: RV Make/Model: License Plate of RV (required info) #: Arriving: _Thu. _Fri. _Sat. No. nights X $20.00 = All RVs will be required to display a valid RV Pass in their windshield. A Pass will be ed to you if you pre-register your RV

6 OFFICIAL OBEDIENCE ENTRY FORM AKC Rules, Regulations, Policies and Guidelines are available on the American Kennel Club website, Mt. Hood Doberman Pinscher Club All-Breed Obedience & Rally Trial FEB ONLY Clark Co. Fairgrounds, Ridgefield, WA Open 12/14/16 8AM.Close 1/20/17 6PM Make checks payable to MHDPC $22 first entry $20 second entry same dog Mail entries with fees to: Karen Langlois, 134 Daves View Dr, Kalama, WA (503) kdlang12@hotmail.com ENCLOSE $ for entry fees (PLEASE PRINT) BREED OBEDIENCE CLASS ADDITIONAL OBEDIENCE CLASS NAME OF (See Back) JUNIOR HANDLER (If any) FULL NAME OF DOG AKC NO. PAL/ILP NO. FOREIGN REG NO. BREEDER SIRE VARIETY JUMP HEIGHT Enter number here DAM 3 ACTUAL OWNER(S) (Please Print) SEX ADDITIONAL OBEDIENCE CLASS DATE OF BIRTH PLACE OF BIRTH (list country) Do not print the above in catalog. JR. HANDLER NUMBER OWNER S ADDRESS CITY STATE ZIP 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 ATTEN- DANCE 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 APPLICA-BLE 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 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. (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, A or B division. 3. 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. of the Rules Applying to Dog Shows.) 4. Dogs listed in the AKC Canine Partners SM Program may be eligible to enter all-breed AKC Obedience trials at the club s option. These dogs should be listed as All American Dog and must include their AKC Number on the entry form and check the AKC No. box. Sire and Dam information shall remain blank for mixed breed entrants. HANDLER: 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 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 Address (An acknowledgement or receipt of entry may be sent to this address): AKC JUNIOR HANDLER NUMBER If this entry is for a Junior Handler, please give the following information: JR. S DATE OF BIRTH 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. 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? AO9999 (05/12) v1.5p Edit

7 OFFICIAL RALLY ENTRY FORM AKC Rules, Regulations, Policies and Guidelines are available on the American Kennel Club website, Mt. Hood Doberman Pinscher Club All-Breed Obedience & Rally Trial Feb ONLY Clark Co. Fairgrounds, Ridgefield, WA Open 12/14/16 8AM.Close 1/ PM Make checks payable to MHDPC $22 first run $20 second run per dog Mail entries with fees to: Karen Langlois, 134 Daves View Dr, Kalama, WA (503) kdlang12@hotmail.com I ENCLOSE $ for entry fees (PLEASE PRINT) BREED RALLY CLASS 2,3 ADDITIONAL RALLY CLASS 2,3 NAME OF (See Back) JUNIOR HANDLER (If any) FULL NAME OF DOG BREEDER SIRE DAM AKC NO. PAL/ILP NO. FOREIGN REG NO. VARIETY JUMP HEIGHT Enter number here DATE OF BIRTH SEX PLACE OF BIRTH (list country) Do not print the above in catalog. JR. HANDLER NUMBER 3 ACTUAL OWNER(S) (Please Print) OWNER S ADDRESS CITY STATE ZIP 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 ATTEN-DANCE 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 APPLICA-BLE 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 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. (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, A or B division. 3. 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. of the Rules Applying to Dog Shows.) 4. Dogs listed in the AKC Canine Partners SM Program may be eligible to enter all-breed AKC Obedience trials at the club s option. These dogs should be listed as All American Dog and must include their AKC Number on the entry form and check the AKC No. box. Sire and Dam information shall remain blank for mixed breed entrants. HANDLER: 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 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 Address (An acknowledgement or receipt of entry may be sent to this address): AKC JUNIOR HANDLER NUMBER If this entry is for a Junior Handler, please give the following information: JR. S DATE OF BIRTH 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. 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? AO9999 (05/12) v1.5p Edit