OBEDIENCE AND RALLY ENTRIES FIRST RECEIVED ENTRY METHOD. ALL OBEDIENCE AND RALLY TRIALS ARE LIMITED TO 8 HOURS COMBINED JUDGING TIME PER TRIAL DAY.

Revised 1/5/17 Graduate Novice Class added AKC Licensed Obedience & Rally Trials Unbenched Premium List Golden Spike Dog Obedience Club, Inc. Obedience and Rally Trial Accepting Entries for All AKC Recognized Breeds & Dogs Listed as ILP, PAL, or AKC Canine Partners OBEDIENCE AND RALLY ENTRIES FIRST RECEIVED ENTRY METHOD. ALL OBEDIENCE AND RALLY TRIALS ARE LIMITED TO 8 HOURS COMBINED JUDGING TIME PER TRIAL DAY. ENTRIES MAY CLOSE EARLY IF JUDGING TIME LIMITS ARE REACHED BEFORE CLOSING DATE. A WAIT LIST WILL BE MAINTAINED. Entries open Wednesday, January 4, 2017 and close Wednesday March 8 th, 2017 at 5:00 p.m. MST After which time entries cannot be accepted, cancelled, altered or substituted except as provided for in Chapter 11, Section 6 of the Dog Show Rules. Legacy Event Center 151 South 1100 West Farmington, Utah 84025 Event Hours: 7:00 a.m. 6:00 p.m. MST THESE TRIALS WILL BE INDOORS IN BUILDINGS #2 & #3, with crating space around the exterior of the rings. One full size obedience trial ring (40 feet by 50 feet) will be set up in each building. OBEDIENCE Friday, March 24, 2017 2017391005 Saturday, March 25, 2017 2017391004 Sunday, March 26, 2017 2017391006 RALLY Friday, March 24, 2017 2017391007 Saturday, March 25, 2017 2017391008 Sunday, March 26, 2017 2017391009 Trial Secretary: Sheryl Harames Make checks payable to Sheryl Harames and mail to: 6537 W 4600 S Hooper, UT 84315 (801) 985-5263 jumpinterriers@gmail.com AKC CERTIFICATION Permission has been granted by the American Kennel Club for the holding of this event under the American Kennel Club rules and regulations. JAMES P CROWLEY, Secretary

GSDOC OFFICERS President... Ann Miller Vice President.... Pat Milburn Secretary 3973 N. 550 W. Pleasant View UT 84414.... Sue Richey Treasurer... Brandy Plowman Training Director... Crystal Toupin BOARD MEMBERS Ina Castillo, Judy Curtin, Jerriann Ernesten, Lydia Kunzler, Crystal Toupin Event Committee Obedience/Rally Show Chairman... Sharon Pearson 1965 Buchanan Ogden, UT 84401-0955 801-564-0178 deafdaisy@yahoo.com Joan Brown, Karen Dorsy, Sharon Pearson, Alan Miller, Ann Miller, Crystal Toupin Important information Emergency Services Police, Ambulance, Fire - 911 SHOW VETERINARIAN (Saturday till noon) Animal Care Center Dr. Pam Nichols 698 West 500 South Bountiful, UT 84010 (801) 294-5960 SHOW VETERINARIAN (Weekend) Animal Emergency Center 2485 North Main Suite #5 Sunset, UT 84015 (801) 776-8118 Maps to the veterinarians will be available at the trial site. Exhibitors should follow their veterinarians recommendation to assure their dogs are free of internal and external parasites, any communicable diseases, and have appropriate vaccinations. Utah State Law requires all dogs over four (4) months of age be current on rabies vaccination. OBEDIENCE TRANSFERS A transfer (i.e., from an obedience class to an obedience class; or a rally class to a rally class) may be requested if, according to the owner s records the handler and dog are eligible and the dog has completed the requirements for the title after the closing date of the trial in which the advanced entry is to be made. Transfers from an A to B class at the same level are allowed provided the host club allows transfers. (When a club does not allow transfers, refer to Section 16b Entry of Ineligible Dog). The request for a transfer must be in writing and presented to the superintendent or trial secretary at least 30 minutes prior to the start of each trial. Transfers may be approved provided the class and judge is available and the class has not reached its limit. Transfer/Move up form is available from the Trial Secretary jumpinterriers@gmail.com or online at http://www.akc.org/pdfs/masterform.cfm. Please be courteous and complete transfer form as soon as possible.

ENTRY FEES Make checks payable to the trial secretary Sheryl Harames and mail to: 6537 W. 4600 S. Hooper, UT 84315. ENTRIES CLOSE at 5:00 p.m. MST WEDNESDAY, March 8, 2017, after which time entries cannot be accepted, canceled, or substituted, except as provided in Chapter 11, Section 6 of the Dog Show Rules. No Exhibition Only or conditional entries will be permitted. Separate fee for each dog each day. When a dog is entered in more than one class the highest priced class is considered the first entry. First OBEDIENCE entry of each dog each day... $25.00 Additional OBEDIENCE entry of each dog each day... $18.00 Jr Handler first obedience entry each dog each day.... $18.00 Jr Handler additional entry of each dog each day... $15.00 OBEDIENCE ENTRY FEES includes a.50 cents AKC recording fee for first entry of each dog and $3.00 event service fee for first entry and $3.00 service fee each additional entry of same dog same day. GSDOC shall assume the responsibility of collecting all event service fees for the American Kennel Club. (American Kennel Club Rule, Chapter 11, Section 2) Obedience entries may close early if time limits are reached before closing date. A wait list will be maintained first received entry method. First RALLY entry of each dog each day... $25.00 Additional Rally entry of each dog each day... $18.00 Jr Handler first rally entry each dog each day... $18.00 Jr Handler additional entry of each dog each day... $15.00 RALLY ENTRY FEES includes $3.50 AKC recording fee for first entry and $3.00 for each additional entry of the same dog same day. GSDOC shall assume the responsibility of collecting all event service fees for the American Kennel Club. (American Kennel Club Rule, Chapter 11, Section 2) Rally entries may close early if time limits are reached before closing date. A wait list will be maintained first received entry method. A wait list will be maintained in order to fill openings created by entries that are withdrawn prior to the event closing day. The full entry fee will be refunded to an entrant whose entry is replaced by a wait-listed entry. Wait-listed entries must be received by the trial secretary prior to closing date and will be first received entry method. Unmarked catalogs are available for $6.00 preorder only. Please indicate on your Entry Form that you wish a catalog and enclose appropriate funds. Dogs owned or co-owned by Club Officers, Trial Chair, Members of the Event Committee, Trial Secretary, and Members of their households will be eligible for entry at this event. OBEDIENCE and RALLY ENTRIES MUST INCLUDE DOG S JUMP HEIGHT WHERE APPLICABLE. As allowed by January 1, 2009 Rule, all Obedience classes that have jumps will be judged in jump height order. March 24, 2017 is tall to small, March 25, 2017 is small to tall, and March 26, 2017 is tall to small. The judging procedure may be modified to accommodate special-needs handlers.

ATTENTION EXHIBITORS The Show Site will be available to exhibitors at 7:00 a.m. each trial day. Dogs must be removed DAILY from the show site immediately following completion of the last scheduled class. No dog under 6 months of age may compete. Bitches in season are strictly prohibited in the buildings. No alcoholic beverages are permitted at the fairgrounds. No flash photography is allowed, except by Show Photographer as needed. Exhibitors MUST be governed by any rules and regulations of Legacy Event Center and/or local restriction. All dogs present must be on leash or confined except when being judged (Utah code 6.16.080, AKC leash restrictions March 2009) or in the fenced dog park located south of the 3 smaller buildings. Failure to comply will result in charges being brought before the Event Committee. Trial grounds are defined as the entire public interior area inside buildings #2 and #3 as well as the grassy area immediately west of the buildings, north and south of the buildings, between the buildings, and south of the big parking lot. The Event Committee reserves the right to make such other regulations as they may deem necessary (not to conflict with AKC rules) on the day of the show. Golden Spike Dog Obedience Club, officers, Trial Secretary, their agents, employees, etc., assume no responsibility for any loss, damage, or injury sustained by exhibitors, handlers, or to any of their dogs or property whether the result of accident or other cause and further assume no responsibility for injury to children. It is distinctly understood that every dog at this trial is under the care, custody, and control of its owner or handler at all times and children are under the care and control of their parent(s) or guardian at all times. Chapter 2, Section 26, Obedience Regulations There will be no intensive or abusive training of dogs on the grounds or premises at an AKC licensed or member obedience trial or sanctioned match. This rule will be strictly enforced; violators will be subject to a Trial Committee hearing. Special training devices that are used to control and train dogs, including but not limited to: collars with prongs, electric collars used with transmitters, muzzles, and head collars may not be used on dogs at AKC Events, except as allowed in the AKC rules, regulations, and policies. No Double handling will be permitted at these trials and attempts to do so from outside the ring will be subject to action by the Event Committee. No entry fees will be refunded if the trial cannot open or be completed by reason of riots, civil disturbances, fire, extreme and/or dangerous weather conditions, an Act of God, public emergency, act of a public enemy, strikes or any other cause beyond the control of the Club or the Trial Secretary. No entry shall be made and no entry shall be accepted which specifies any condition as to its acceptance. Entries will not be accepted without correct fees or signatures. Changes, additions, or corrections to entry forms must be received in writing or by email prior to close of entries. Those received by telephone are not acceptable. Entries will be acknowledged no later than after entries close with an entry acknowledgement and judging program mailed to email or home address on entry (if you wish your Agent to receive an acknowledgement of your entry and/or judging schedule, please submit request with entry, show name and Agent s correct email address for this courtesy.) Should exhibitor NOT receive an acknowledgement within a reasonable amount of time please notify the Trial Secretary at jumpinterriers@gmail.com.

Exhibitors are responsible for cleaning up after their dog(s). Any exhibitor failing to do so may be excused without benefit of refund if the Trial Committee deems the exhibitor to be in violation of this requirement. Cleaning supplies and disposal sites will be available at various locations around the show grounds. Prizes will be awarded at each trial. All prizes must be claimed the day of the trial. None will be mailed. The club reserves the right to substitute a prize of equal or greater value. NOTICE TO EXHIBITORS The American Kennel Club Rules and Regulations will govern these Trials. 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 Trials Premium List. CANADIAN EXHIBITORS MUST SUBMIT ENTRIES WITH CHECKS DRAWN ON U.S. ACCOUNTS OR WITH INTERNATIONAL MONEY ORDERS IN U.S. FUNDS Returned Checks do not constitute a valid entry fee. In the event of a returned check, a replacement check will not be acceptable and guaranteed funds will be required. Guaranteed funds are defined as Money Order, Cashier s Check, or Cash. The Trial Secretary will add a collection fee of $25.00 to the amount of each returned check. Subsequent returned checks from the same exhibitors may result in their being put on a CASH ONLY basis. Entry Fees will not be refunded in the event that a dog is absent, disqualified, excused by Veterinarian or judge or barred from competition by action of the Event Committee, except as noted above. Entry Fees will not be refunded after the closing date and time. Anyone wishing to withdraw entries must do so in writing prior to the closing date and time. To economize show costs, a significant portion of communication with Exhibitors will be delivered via email. Be sure to add jumpinterriers@gmail.com to your trusted email friends to prevent loss or delay of delivery of important information regarding this show and/or your entry. A printed copy of the premium list may be requested by emailing the Trial Secretary DIRECTIONS TO TRIAL SITE From the North: Take I-15 toward Salt Lake City. Take EXIT 325 toward Lagoon/Park Dr/Farmington. Turn RIGHT at the light onto PARK LN. Continue west. After the Station Parkway light merge left to left turn lane. Turn left at the light onto 1100 West. Continue south around the roundabout. End at 151 S 1100 West. From the South: Take I-15 North from Salt Lake City. Take the US-89 N exit, EXIT 324 toward I-84 E/So Ogden. Take EXIT 395 toward Farmington. Turn LEFT onto PARK LN. Continue west. After the Station Parkway light merge left to left turn lane. Turn left at the light onto 1100 West. Continue south around the roundabout. End at 151 S 1100 West. Directions to buildings #2 and #3: Three blue/grey buildings are located southeast of the large parking lot. Building #2 is in the center, #3 is south of building #2.

OBEDIENCE TRIAL INFORMATION Judges are limited to 8 hours of judging. Entries will close earlier than the specified closing date of March 8 th, 2017 at 5:00 pm, MST if the judging time limit is reached. A wait list first received entry method will be maintained to fill openings created by entries that are withdrawn prior to the event closing date. (Chapter 1, Section 27) Judges may take lunch or breaks at their discretion. One full size obedience trial ring (40 feet by 50 feet) will be set up in each building. Obedience entries must include dog s jump height where applicable. For your convenience a Fillable Obedience entry form can be found at http://www.akc.org/pdfs/masterform.cfm. There is also a printable entry form located in this premium. NOTE: Refund of entry fees (less $6.50) for bitches entered in Obedience that are in season the day of this trial may be obtained provided that a veterinarian s certificate and a request in writing is received by the trial secretary no later than 30 minutes prior to the start of the trial. Judging begins at 8:00 AM MST each day. JUDGES: Jill K Jones, 34803 Ranch Dr., Brownsville, OR 97327-9787 Dr. Hallie Ray, 6 Autumn Ct., Edgewood, NM 87015-9405 OBEDIENCE JUDGING ASSIGNMENTS Bldg Numr Obedience Classes Friday March 24, 2017 Saturday March 25, 2017 Sunday March 26, 2017 2 2 2 Beginner Novice A Beginner Novice B Preferred Novice Jill K Jones Dr. Hallie Ray Jill K Jones Jill K Jones Dr. Hallie Ray Jill K Jones Jill K Jones Dr. Hallie Ray Jill K Jones 2 Novice A Jill K Jones Dr. Hallie Ray Jill K Jones 2 Novice B Jill K Jones Dr. Hallie Ray Jill K Jones 3 3 Graduate Novice Preferred Open Dr. Hallie Ray Jill K Jones Dr. Hallie Ray Dr. Hallie Ray Jill K Jones Dr. Hallie Ray 3 Open A Dr. Hallie Ray Jill K Jones Dr. Hallie Ray 3 Open B Dr. Hallie Ray Jill K Jones Dr. Hallie Ray 3 Preferred Utility Dr. Hallie Ray Jill K Jones Dr. Hallie Ray 3 Utility A Dr. Hallie Ray Jill K Jones Dr. Hallie Ray 3 Utility B Dr. Hallie Ray Jill K Jones Dr. Hallie Ray

Obedience Ribbons & Prizes First Prize... Blue Ribbon Second Prize... Red Ribbon Third Prize... Yellow Ribbon Fourth Prize... White Ribbon Qualifying Score in Obedience Classes... Green Ribbon High In Trial in Regular Classes... Blue and Gold Rosette Highest Combined Score in Regular Open B & Utility... Blue and Gold Rosette High In Trial in Preferred Classes... Blue and Gold Rosette Highest Combined Score in Preferred Open B & Utility... Blue and Gold Rosette New title rosettes are available for exhibitors completing a title at this trial. Qualifying Score required for all prizes in Regular & Optional Titling Classes. Additional prizes are noted below. Friday For Highest Combined Score in Regular Open B and Utility Class: $30.00 offered by the Golden Spike Dog Obedience Club For High In Trial in Regular Classes: $20.00 Offered by the Golden Spike Dog Obedience Club For Highest Combined Score in Preferred Open B and Preferred Utility Class: $30.00 offered by the Golden Spike Dog Obedience Club For High In Trial in Preferred Classes: $20.00 offered by the Golden Spike Dog Obedience Club First place in all classes: $10.00 Petsmart/Petco Gift Card Goodie bag for all qualifiers offered by Sharon Pearson. Saturday For Highest Combined Score in Open B and Utility Class: $30.00 offered by the Golden Spike Dog Obedience Club For High In Trial in Regular Classes: $20.00 Offered by the Golden Spike Dog Obedience Club For Highest Combined Score in Preferred Open and Preferred Utility Class: $30.00 offered by the Golden Spike Dog Obedience Club For High In Trial in Preferred Classes: $20.00 offered by the Golden Spike Dog Obedience Club First place in all classes: $10.00 Petsmart/Petco Gift Card Goodie bag for all qualifiers offered by Sharon Pearson. Sunday For Highest Combined Score in Open B and Utility Class: $30.00 offered by the Golden Spike Dog Obedience Club For High In Trial in Regular Classes: $20.00 Offered by the Golden Spike Dog Obedience Club For Highest Combined Score in Preferred Open and Preferred Utility Class: $30.00 offered by the Golden Spike Dog Obedience Club For High In Trial in Preferred Classes: $20.00 offered by the Golden Spike Dog Obedience Club First place in all classes: $10.00 Petsmart/Petco Gift Card Goodie bag for all qualifiers offered by Sharon Pearson. Golden Spike Dog Obedience club would like to extend a special Thank You to the following for their generous donation to high combined & high in trial scoring dog/s in the regular obedience classes. It is greatly appreciated. Helena Carney, Ann Miller, Kathy Murray, Kristie Rasmussen, and Laurie Spease

OBEDIENCE TRANSFER FORM Name of Club Date Dog s AKC Name Dog s AKC # Breed Sex Please circle the class and indicate the level that was originally entered A or B. Novice Open Utility Beginner Novice Pre-Novice Pre-Open Pre-Utility Graduate Novice Transfer Entry to Class: (Circle one class) Level: A or B / Jump Height: Novice Open Utility Beginner Novice Pre-Novice Pre-Open Pre-Utility Graduate Novice Print Owner s Name: Handler s Name: (If applicable) Signature of owner or agent: Duly authorized to make this entry: Signature of Trial Secretary Or Superintendent if approved: Date: Time Received:

RALLY TRIAL INFORMATION Judges are limited to 8 hours of judging. Entries will close earlier than the specified closing date of March 8 th, 2017, at 5:00 p.m. MST if the judging time limit is reached. A wait list first received entry method will be maintained to fill openings created by entries that are withdrawn prior to the event closing date. (Chapter 1, Section 27) For your convenience a Fillable Rally entry form can be found at http://www.akc.org/pdfs/masterform.cfm. A printable entry form is also located in this premium. Rally entries must include dog s jump height where applicable. Rally ring size is 40 X60. NOTE: Refund of entry fees (less $6.50) for bitches entered in Rally that are in season the day of this show may be obtained provided that a veterinarian s certificate and a request in writing is received by the trial secretary no later than 30 minutes prior to the start of the trial. JUDGES: Jill K Jones, 34803 Ranch Dr., Brownsville, OR 97327-9787 Dr. Hallie Ray, 6 Autumn Ct., Edgewood, NM 87015-9405 Rally Trial judging will begin at the conclusion of the obedience classes each day. RALLY JUDGING ASSIGNMENTS Bldg Numr Rally Classes Friday March 24, 2017 Saturday March 25, 2017 Sunday March 26, 2017 2 Novice A Jill K Jones Dr. Hallie Ray Jill K Jones 2 Novice B Jill K Jones Dr. Hallie Ray Jill K Jones 2 Advanced A Jill K Jones Dr. Hallie Ray Jill K Jones 2 Advanced B Jill K Jones Dr. Hallie Ray Jill K Jones 2 Excellent A Jill K Jones Dr. Hallie Ray Jill K Jones 2 Excellent B Jill K Jones Dr. Hallie Ray Jill K Jones RALLY TRIAL PRIZES for REGULAR CLASSES First Prize... Blue Ribbon Second Prize... Red Ribbon Third Prize... Yellow Ribbon Fourth Prize... White Ribbon New title rosettes are available for exhibitors completing a title at this Trial. Rally High Combined Advanced & Excellent class $30.00 offered by GSDOC. First Place in all rally classes $10.00 PetsMart/PetCo gift card offered by GSDOC. Goodie bag for all qualifiers offered by Sharon Pearson.

RALLY TRANSFER FORM Name of Club Date Dog s AKC Name Dog s AKC # Breed Sex Please circle the class and indicate the level that was originally entered. Level: A or B Novice Advanced Excellent Transfer Entry to Class: (Circle one class) Level: A or B Jump Height: / Novice Advanced Excellent Other: Print Owner s Name: Handler s Name: (If applicable) Signature of owner or agent: Duly authorized to make this entry: Signature of Trial Secretary Or Superintendent if approved: Date: Time Received:

HOTEL INFORMATION These motels have graciously agreed to accept our well-mannered dogs. Please let establishment know when making reservations that you have dogs. Do NOT leave dogs unattended in rooms. Please clean up after your dogs and follow rules so that these motels will continue to allow dogs. There may be other accommodations in the area. A pet deposit may be required. Please check with motels for policies and restrictions. Cottontree Inn 1030 N 400 E, North Salt Lake, UT 84025 (800) 662-6886 or (801) 282-7666 Days Inn 572 N. Main St, Clearfield, UT 84015 (801) 825-8000 www.daysinn.com Hampton Inn Bountiful 2393 S 800 W, Woods Cross, UT 84087 (888) 834-4470 or (801) 296-1211 Hampton Inn & Suites 332 West Park Lane, Farmington, UT 84025 (801) 451-7999 Hampton Inn Layton 1702 N Woodland Drive, Layton, UT 84041 (801) 775-8800 www.laytonhampton.com LaQuinta Inn and Suites 1965 N, 1200 W, Layton, UT 84041 (801) 776-6700 Motel 6 2433 S 800 W, Woods Cross, UT 84087 (800) 466-8356 or (801) 298-0289 www.motel6.com Davis County Legacy Event Center (Show Site) 151 S 1100 W, Farmington, UT 84025 (801) 451-4080 8:30 a.m. to 5:00 p.m. Monday-Friday Complete hook ups: Power & water - $30.00 per night Dry Camping: No hook-ups no charge

Lunch is provided by Green Apple Catering, Deborah Coffin, (801) 628-4499 Lunch will be provided for ring stewards and judges. Exhibitors may preorder/prepay for lunches for $6.00 per lunch per day. If you wish to order lunch include the below order and appropriate funds with your entry. Friday March 24 th, 2017. Number of lunches. Amount enclosed w/entry Menu: Chicken Pasta Salad, Roll/Butter, Brownie Saturday March 25 th, 2017, Number of lunches Amount enclosed w/entry Menu: Chili, Cornbread Muffin, Carrot/Celery Sticks Sunday March 26 th, 2017, Number of lunches Amount enclosed w/entry Menu: Deli Sandwiches, Fruit salad, Chips

Breed 4 Variety 1 Obedience Class 2,3 OFFICIAL OBEDIENCE ENTRY FORM I have enclosed $ for my total entry fees IMPORTANT Read Instructions on reverse side carefully before filling out. Numbers in the boxes indicate sections of the instructions relevant to the information needed in that box (PLEASE PRINT). Next, be sure to read the Agreement and sign on the reverse. No form will be processed without your signature! Additional Obedience Class 2,3 Jump Height Sex Additional Obedience Class 2,3 Additional Obedience Class 2,3 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.) 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. Name of Junior Handler (If Any) Junior Handler Number AKC Rules, Regulations, Policies and Guidelines are available on the American Kennel Club website: www.akc.org Full Name of Dog 4 AKC No. Enter number here Breeder Sire Dam Actual Owner(s) (Please Print) Owner s Address Foreign Reg No. Email Address (An acknowledgement or receipt of entry may be sent to this email address) Name of Agent/Handler at the Show (If any) Place of Birth (Enter Country below) Do not print the country in catalog Date of Birth City State/Prov Zip/Postal Code Country (if not USA) Telephone # Are you a new exhibitor? Yes No AGREEMENT 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 any additional rules and regulations appearing in the premium list of this event and entry form and any decision made in accord with them. I (we) agree that the club holding this event has the right to refuse this entry for cause which the club shall deem sufficient. I (we) certify and represent that the dog entered is not a hazard to persons or other dogs. 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 the determination of whether the injury is serious shall be made by the event veterinarian and is binding on me (us). 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 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. Signature of owner or his agent duly authorized to make this entry: Telephone Email *** Be sure to read the Agreement and sign on the reverse. No form will be processed without your signature! *** AO9999 (01/14) v1.4 P Edit

OFFICIAL AKC RALLY ENTRY FORM I have enclosed $ for my total entry fees IMPORTANT Read Instructions on reverse side carefully before filling out. Numbers in the boxes indicate sections of the instructions relevant to the information needed in that box (PLEASE PRINT). Next, be sure to read the Agreement and sign on the reverse. No form will be processed without your signature! Breed 4 Variety 1 Rally Class 2,3 Additional Rally Class 2,3 Jump Height Sex Additional Rally Class 2,3 Additional Rally Class 2,3 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.) 4. Dogs listed in the AKC Canine Partners SM Program may be eligible to enter all-breed AKC Rally 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. Name of Junior Handler (If Any) Junior Handler Number AKC Rules, Regulations, Policies and Guidelines are available on the American Kennel Club website: www.akc.org Full Name of Dog Breeder Sire Dam AKC 4 No. Enter number here Actual Owner(s) (Please Print) Owner s Address Telephone # Foreign Reg No. Email Address (An acknowledgement or receipt of entry may be sent to this email address) Place of Birth (Enter Country below) Do not print the country in catalog Date of Birth City State/Prov Zip/Postal Code Country (if not USA) Are you a new exhibitor? Yes No AGREEMENT 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 any additional rules and regulations appearing in the premium list of this event and entry form and any decision made in accord with them. I (we) agree that the club holding this event has the right to refuse this entry for cause which the club shall deem sufficient. I (we) certify and represent that the dog entered is not a hazard to persons or other dogs. 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 the determination of whether the injury is serious shall be made by the event veterinarian and is binding on me (us). 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 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. Signature of owner or his agent duly authorized to make this entry: Telephone Email Name of Agent/Handler at the Show (If any) *** Be sure to read the Agreement and sign on the reverse. No form will be processed without your signature! *** AOR999 (01/14) v1.45p Edit