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 Event # 20066237604 Premium List 1 Specialty and 2 AKC All-Breed Agility Trials (Licensed by the American Kennel Club September 22-24 2006 Countryside Agility Training Center 220 W Plum Suite 600 St Edinboro Pa 16412 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: Sara Reiter (fri) Blair Kelly (sat/sun) entries are LIMITED to 330 runs per day. Entries will be taken by Random Draw method Draw Opening Date: 7/5/06 at 8 am Draw Close 7/17/06 6pm.. Draw will be on 7/18/06 at 10 am. Draw will be held at the residence of Shelley Stemple 4651 Nye Rd W Springfield PA 16443 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 16443 (814)922-3741 Email: Countrysideas3@aol.com Entry fees per dog per day: (includes AKC recording fee) $20 First entry $12 Second entry (same dog) each day As this trial is limited, you may contact me by email to see if you got in. Please include email on entry so I may contact you, if needed. Entries close on 9/5/06 at 6 PM. Entry form changes, additions, corrections, and cancellations MUST be received in writing by closing. Move ups will be accepted until Monday Sept 18 th at 6 PM. No telephone changes accepted. Day to day move-ups will be accepted. President: Jacey Holden 3991 W Peltier Rd, Lodi, CA 95242 Vice-Pres Lisa Pasquarello.840 Cherry Hill Lane Pottstown, PA 19465 Secretary: Larry Weiss...4772 Carrington Dr Oakley, CA 94561 Treasurer: Tisha Harris 9975 Madison Twp Rd #57 Roseville,OH 13777 Trial Committee Chairperson: Norma Hornung 230 Falls Village Rd Pittsburgh, PA 15239 Email : pepperpaws@alltel.net Members: Norma Hornung, Joanne Takata, Eunice Giles, Karen Groth, Mark Giles Trial Secretary Shelley Stemple 4651 Nye Rd W. Springfield, PA 16443 (814) 922-3741, CountrysideAS3@aol.com Veterinarian on Call Pet Emergency Center (814) 866-5920 418 W 38 th St Erie PA 16509 Trial Judges All Friday classes Sara Reiter 283 Williams Rd Windsor, NY 13865-2438 AllSat/Sun classes Blair Kelly 1309 Beltram Ct Odenton, MD 21113-2102 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: Email : Phone Agility Trial Move-Up Use this form to move up to a higher agility class only Sept 22-24 2006 Breed: Sex: - Move Entry to: (Please circle) Std Class: Open Excellent A Excellent B JWW: Open Excellent A Excellent B Jump height Division: 4 8 12 16 20 24 26 Days dog is entered : Fri Sat Sun Dogs AKC Registered Name: AKC Reg. No.: ILP No.: Foreign Reg. No.: Dogs Call Name: Owners Name: Handlers 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 astuffed 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. A special MACH ribbon and MACH bar will be awarded to any dog earning a MACH at this trial Friday trial ( Shiba Only) Trophies Friday High in Trial Standard and High in Trial JWW Rosette and Framed Copper & Pewter Etching with Shiba motif Oldest Shiba to earn a qualifying leg in Novice (10 oz package of dog treats) * New Title medallions * Mug with a Shiba design for a Shiba earning a qualifying score on its 1st run at its first trial. * Highest Scoring Shiba with an ILP number (cotton throw embroideredwith a Shiba design) * $50 gift certificate to Clean Run for any Shiba/handler team that earns qualifying scores in Std Agility, JWW agility, Rally, AND Regular Obedience classes. Hotel Information Red Roof Inn 7865 Perry Highway Erie PA 814 868-5246 I90 Exit 27 (17 min) 16509 Motel 6 7875 Peach St Erie PA 16509 814-864-4811 I90 Exit 24 (15 min) Comfort Inn 8051 Peach St Erie PA 16509) 814-866-6666 Erie I90 Exit 24 (15 min) Edinboro Inn Edinboro, Pa (2 min) Camping on site 401 West Plum St Edinboro PA 814-734-5650 16428 Camping available in parking lot no charge Directions to Show site 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. Ring will be 85x100 on ½ matting with ring gating Electronic timing will be used 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 24/26 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 dogs must be measured). Regular class Preferred class 8 inches... For dogs 11 inches and under at the withers.. 4 12 inches...for dogs 14 inches and under at the withers.. 8 16 inches...for dogs 18 inches and under at the withers.. 12 20 inches...for dogs 22 inches and under at the withers.. 16 24 inches... For dogs over 22 inches at the withers 20 26 inches For all dogs Aframe will be set at 5 7 See complete rules in the Regulations for Agility Trials available at www.akc.org 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 19 2006. 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. Exhibitors should follow their vets recommendations to assure their dogs are free of internal and external parasites, any communicable diseases, and have appropriate vaccinations."
Official American Kennel Club Entry Form September 22-24 2006 Friday Sept 22, Standard SHIBA ONLY!!!! Friday Sept 22 JWW Saturday Sept 23 Standard all breed Saturday Sept 23 JWW Sunday Sept 24 Standard all breed Sunday Sept 24 JWW ENTRY FEE: (Including AKC recording fees) is $20.00 for each dog entered in first run and $12.00 for same dog entered in second run. Trial closes on 9/5/06 at 6 Pm. Make checks payable in US Funds to : NSCA, and mail to: Shelley Stemple 4651 Nye Rd W Springfield PA 16443. ***** 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 8 12 16 20 24 26 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 4 8 12 16 20 NON-REGULAR AGILITY CLASSES: INTERNATIONAL SWEEPSTAKES CLASS JUMP height (circle one) (if offered) STD JWW (circle one) 14 18 26 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 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, www.akc.org 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 owneor his agent duly authorized to make this entry telephone email: 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) 816-3776. 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)