Car-Dun-Al O.D.T.C. Heidi Nelson 9443 Rainsford Drive Huntley, IL 60142 Premium List AKC Obedience & Rally Trials Obedience Event # s 2019055005 & 2019055006 Rally Event # s 2019055003 & 2019055004 Unbenched - Indoors (Licensed by the American Kennel Club) Two Back-To-Back Obedience and Rally Trials Saturday & Sunday February 2 & 3, 2019 Car-Dun-Al ODTC Building 10783 Wolf Drive Huntley, Illinois 60142 DO NOT mail entries to this address Trial Hours: 7:00 to 6:00 P.M. CST. Entries will be accepted for dogs listed in the AKC Canine partners Program Rally is limited to 100 entries per day. Obedience is limited to 8 hours of judging per day Certification: Permission has been granted by the American Kennel Club for holding this event under American Kennel Club Rules and Regulations. Gina DiNardo, Secretary
Car-Dun-Al Obedience Dog Training Club Officers President Jerry McEvilly 1 st. Vice President Carol Preble 2 nd. Vice President Bonnie Morrow Corresponding Secretary Martha LaLoggia 9265 S Union Rd, Huntley, IL. 60142 Recording Secretary Heidi Nelson Treasurer John Opatrny Director of Training Ed Ronan Director of Agility Carol Ronan Board of Directors: Jean Munger and Michael Ammer Trial Secretary - Heidi Nelson 9443 Rainsford Drive Huntley, IL 60142 847-669-1815 hniwu@yahoo.com Trial Chairman - Fay Schafernak 2440 North Drury Lane - Arlington Heights, IL 60004 847-530-8157 - Fay.schafernak@comcast.net OBEDIENCE TRIAL TROPHY & PRIZE LIST RIBBON PRIZES - ALL OBEDIENCE CLASSES First Place.. Blue Rosette Second Place. Red Rosette Third Place.Yellow Rosette Fourth Place White Rosette Highest Scoring Dog in Regular Classes.....Blue & Gold Rosette Highest Combined Score in Open B & Utility.Blue & Green Rosette A Green Ribbon will be awarded to each dog receiving a Qualifying Score. SPECIAL PRIZES HIGHEST SCORING DOG IN TRIAL $25 Cash HIGHEST SCORING COMBINED OPEN B & UTILITY..$25 Cash NOVICE A HIGHEST SCORING DOG IN CLASS Antique Bronze-Tone First Place Trophy SECOND HIGHEST SCORING DOG IN CLASS Antique Bronze-Tone Second Place Trophy THIRD HIGHEST SCORING DOG IN CLASS Antique Bronze-Tone Third Place Trophy FOURTH HIGHEST SCORING DOG IN CLASS Antique Bronze-Tone Fourth Place Trophy Toys will be awarded to all Novice A Qualifiers. NOVICE B OPEN A & B UTILITY A & B HIGHEST SCORING DOG IN CLASS.$20 Cash BEGINNER NOVICE A Toys will be awarded to all Beginner Novice A Qualifiers. RALLY TRIAL TROPHY & PRIZE LIST NOVICE A & B, INTERMEDIATE, ADVANCED A & B, EXCELLENT A & B & MASTER RIBBON PRIZES - ALL RALLY CLASSES Committee Judges Chairman: Ring Stewards: Judges Hospitality: Ribbons & Prizes: Hospitality: Fay Schafernak Patti Burgess Victoria Roush Anita Koss Kari Schmidt Highest Combined Score in Adv. B & Excel. B...Blue & Green Rosette High Scoring Triple Q (Adv. B, Excellent B & Master) Blue and Red Rosette First Place.. Blue Rosette Second Place. Red Rosette Third Place.Yellow Rosette Fourth Place White Rosette SPECIAL PRIZES HIGHEST COMBINED SCORE IN ADV. B & EXCEL. $25 Cash HIGH SCORING TRIPLE Q...$25 Cash A Green Ribbon will be awarded to each dog receiving a Qualifying Score. Toys will be awarded to all Novice A Qualifiers. ALL PRIZES MUST BE PICKED UP NONE WILL BE MAILED
Obedience Entry Fees: $27.00 first entry $20.00 second entry same dog/same day. Rally Entry Fees: $27.00 first entry $20.00 second entry same dog/same day. Entries Close: Wednesday, January 16, 2019 at 6:00 pm. Or when limits are reached if before January 16, 2019, after which time entries cannot be accepted, canceled or substituted, except as provided for in Chapter 11, Sec 6 of the Rules Applying to Dog Shows Transfers will be allowed per Chapter 1, Sec 16 of the Obedience Regulations. Make checks payable to: Car-Dun-Al ODTC and send with entry forms to: Heidi Nelson, 9443 Rainsford Drive, Huntley IL 60142 Saturday Judges Beginner Novice A & B, Novice A & B, Preferred Novice Barbara Wedekind-Selton - 4305 W 99TH ST, BLOOMINGTON, MN 55437 Open A, Open B, Preferred Open, Graduate Novice Robert T. Self, Jr. - 2310 US HIGHWAY 150N, WATAGA, IL 61488-9520 Utility A & RALLY Robert M. Burgin 3118 BAYBERRY DR SW, CEDAR RAPIDS, IA 52404-3822 Utility B, Preferred Utility, Graduate Open & Versatility- Dianne Allen 3213 W. 3000S RD, KANKAKEE, IL 60901-7866 Sunday Judges Beginner Novice A & B, Novice A & B, Preferred Novice Robert T. Self, Jr. - 2310 US HIGHWAY 150N, WATAGA, IL 61488-9520 Open A, Open B, Preferred Open, Graduate Novice Barbara Wedekind-Selton - 4305 W 99TH ST, BLOOMINGTON, MN 55437 Utility A & RALLY Dianne Allen 3213 W. 3000S RD, KANKAKEE, IL 60901-7866 Utility B, Preferred Utility, Graduate Open & Versatility Robert M. Burgin 3118 BAYBERRY DR SW, CEDAR RAPIDS, IA 52404-3822 Obedience Trial classes Novice A & B, Open A & B, Utility A & B, UDX Optional Titling Classes Beginners Novice A & B, Graduate Novice, Graduate Open & Versatility Alternative Titling Classes Preferred Novice, Preferred Open and Preferred Utility Rally Classes Novice A & B, Intermediate, Advanced A & B, Excellent A & B & Master, RAE, RACH ARE YOU ENTERED IN THE CORRECT CLASS IN RALLY?? If you have any obedience title on a dog. You must enter Rally Novice B, Advanced B or Excellent B. Please read the rules if you are unsure as AKC will take away your legs if you are in the wrong class. TRANSFERS will be allowed at this trial As per Chapter 1, section 16a,b <><><><><> PLEASE NOTE <><><><><> We will send you an e-mail confirmation of your entry. Please confirm that everything is correct on your entry. If you do not receive an e-mail within 10 days. Please send me an e-mail inquiring as I might have not received it or I might have gotten your e-mail address wrong in my database. My e-mail address is hniwu@yahoo.com PLEASE Pick Up after your dog. Anyone caught not picking up will be asked to leave without refund of entries.
Directions to Show site: From the east or West on I-90: Exit Route 47 (electronic I-PASS only) Go north on Route 47 approximately 3.7 miles to Oakcrest Drive and turn left (known as Algonquin Road to the right). Go less than.1 miles on Oakcrest to Wolf Drive and turn left into industrial complex. Take 1st Right drive to back then turn Left. The trial is at the far end of building. GPS coordinates N 42.10.454 W 088.26.040. IMPORTANT : TO ALL EXHIBITORS Please read carefully-- In order for us to be able to keep renting this facility please adhere to these rules. Please note that the building will NOT OPEN UNTIL 6:30 AM. DO NOT COME ANY EARIER THAN 6:30 AM We know that some of your dogs are very exuberant and can t help but bark. For those that are not able to prevent your dogs from barking, please park in between the buildings so our neighbors in homes to the west aren't disturbed. Please don't walk your dogs along the fence on the west side of the drainage area. There is a lot of area to walk on the east side of the drainage area and along the south side of the buildings. Please do not park in parking spots right in front of the gymnastic club or ANY of the businesses in the complex. If we find anyone NOT following these rules they will be asked to leave without refund of entry fees. Please be sure to Print Clearly on your entry form. Include the following: Agreement on the back side of entry Signed Entry Form E-mail and phone on entry. E-Mail confirmations will be sent to all with e-mail addresses. Appropriate fees Thanks.. VETERINARIAN ON CALL Companion Animal Specialty & Emergency Hospital 1095 Pingree Road-Suite-120 Crystal Lake, IL 60014 815-479-9119 Directions from show site: Turn Right on Oakcrest Dr./Algonquin Road for 4.7 miles, then turn left on Randall Road for 4.4 miles (road name changes to James Rakow Road). Turn right on Pingree Road. Vet is in strip mall on left at corner of Rakow and Pingree. MOTEL ACCOMMODATIONS The following establishments have graciously agreed to accept guests with canine companions. However, we must rely on your assistance in keeping this privilege available. -- Please call to verify that pet policy has not changed. Best Western Inn - 990 Lake Ave Woodstock, IL 60098 506-739-0000 9.44 miles from show site Super 8 1220 Davis Road, Woodstock, IL 60098 815-337-8808 8.7 miles from show site Super 8 577 Crystal Point Dr, Crystal Lake, IL 60014 815-788-8888 8.7 miles from show site Additional Notice to Exhibitors PLEASE NO UNENTERED DOGS RETURNED CHECKS does not constitute a valid entry fee. ENTRY FEE shall not be refunded in the event that a dog is absent, disqualified, excused by the veterinarian or judge or barred from competition by action of the Trial Committee. BITCHES IN SEASON Entries shall be refunded less $5.00 for bitches that come in season after the closing date with proof from their veterinarian provided to the Trial Secretary by 8:00 A.M. the day of the trial. NO ENTRY FEES will be returned if show cannot open or be completed by reasons of riots, civil disturbances, fire, act of god, public emergencies, act of public enemy, strikes, or any other causes beyond the control of Car-Dun-Al Obedience Dog Training Club, Inc. ERRORS ON ENTRY BLANKS Owners are responsible for errors in making out entry forms, whoever may make such errors, and no entry fee will be refunded in event of such errors or cancellation of entries after the published closing date. There will be no refund for duplicated entries. We will make every effort to find all duplicate entries but if the entry has been processed, no refund will be made. DOGS MAY ARRIVE anytime prior to their scheduled time of judging, dogs not required for further judging will be excused. ENTRIES Must Be Made On Official AMERICAN KENNEL CLUB ENTRY FORMS. With the agreement printed on the reverse side, signed at the bottom by the owner or the owners duly authorized agent, otherwise entry cannot be accepted.
AKC Rules, Regulations, Policies and Guidelines are available on the American Kennel Club Web site, www.akc.org 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 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 name. State on entry form whether transfer application has been mailed to the 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? AEN999 (4/04) OFFICIAL AMERICAN KENNEL CLUB ENTRY FORM Car-Dun-Al Obedience Dog Training Club, Inc. Event # s 2019055003, 2019055004, 2019055005, 2019055006 Car-Dun-Al ODTC training Building 10783 Wolf Drive, Huntley, Illinois 60142 Saturday February 2, 2019 - Obedience - $27.00 1 st. Entry & $20.00 2nd entry Sunday February 3, 2019 - Obedience - $27.00 1 st. Entry & $20.00 2nd entry Saturday February 2, 2019 - Rally - $27.00 1 st. Entry & $20.00 2nd entry Sunday February 3, 2019 - Rally - $27.00 1 st. Entry & $20.00 2nd entry Pre-Paid Catalog $5.00 ENTRIES CLOSE: 6:00 p.m. Wed. Jan.16, 2019 after which time entries cannot be accepted, canceled or substituted, or when limits are reached. (includes $1.50 AKC Event Service Fee and $.50 Recording fee. MAIL ENTRIES with Fees Payable to Car-Dun-AL O.D.T.C. to Trial Secretary: Heidi Nelson, 9443 Rainsford Drive, Huntley IL 60142 IMPORTANT: Read carefully instructions on reverse side before filling out. Numbers in the boxes indicate sections of the instructions relevant to the information needed in that box. PLEASE PRINT. Breed Variety (1) Sex Dog Show Class (2)(3) Additional Classes Class (3) Division Weight, Color, Etc OBEDIENCE Class Jump Height UDX RALLY CLASS RAE RACH Jump Height Name of (See Back) Junior Handler AKC Registered Name Of Dog AKC Reg. No. AKC Litter No. ILP/PAL No. Foreign Reg. No. & Country Breeder Sire Dam Actual Owner(s) Please Print Owners Address City, State, & Zip Code + 4 Jr. Handler AKC # Date of Birth Place of Birth USA Canada Foreign 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 show or obedience trial or agility trial, 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 representations and agreements. SIGNATURE OF OWNER (PARENT OR GUARDIAN IF HANDLER IS A AREA CODE & PHONE NO. MINOR) OR THE AGENT DULY AUTHORIZED TO MAKE THIS ENTRY E-MAIL ADDRESS
AKC Rules, Regulations, Policies and Guidelines are available on the American Kennel Club Web site, www.akc.org 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 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 name. State on entry form whether transfer application has been mailed to the 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? AEN999 (4/04) OFFICIAL AMERICAN KENNEL CLUB ENTRY FORM Car-Dun-Al Obedience Dog Training Club, Inc. Event # s 2019055003, 2019055004, 2019055005, 2019055006 Car-Dun-Al ODTC training Building 10783 Wolf Drive, Huntley, Illinois 60142 Saturday February 2, 2019 - Obedience - $27.00 1 st. Entry & $20.00 2nd entry Sunday February 3, 2019 - Obedience - $27.00 1 st. Entry & $20.00 2nd entry Saturday February 2, 2019 - Rally - $27.00 1 st. Entry & $20.00 2nd entry Sunday February 3, 2019 - Rally - $27.00 1 st. Entry & $20.00 2nd entry Pre-Paid Catalog $5.00 ENTRIES CLOSE: 6:00 p.m. Wed. Jan. 16, 2019 after which time entries cannot be accepted, canceled or substituted, or when limits are reached. (includes $1.50 AKC Event Service Fee and $.50 Recording fee. MAIL ENTRIES with Fees Payable to Car-Dun-AL O.D.T.C. to Trial Secretary: Heidi Nelson, 9443 Rainsford Drive, Huntley, IL 60142 IMPORTANT: Read carefully instructions on reverse side before filling out. Numbers in the boxes indicate sections of the instructions relevant to the information needed in that box. PLEASE PRINT. Breed Variety (1) Sex Dog Show Class (2)(3) Additional Classes Class (3) Division Weight, Color, Etc OBEDIENCE Class Jump Height UDX RALLY CLASS RAE RACH Jump Height Name of (See Back) Junior Handler AKC Registered Name Of Dog AKC Reg. No. AKC Litter No. ILP/PAL No. Foreign Reg. No. & Country Breeder Sire Dam Actual Owner(s) Please Print Owners Address City, State, & Zip Code + 4 Jr. Handler AKC # Date of Birth Place of Birth USA Canada Foreign 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 show or obedience trial or agility trial, 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 representations and agreements. SIGNATURE OF OWNER (PARENT OR GUARDIAN IF HANDLER IS A AREA CODE & PHONE NO. MINOR) OR THE AGENT DULY AUTHORIZED TO MAKE THIS ENTRY E-MAIL ADDRESS