Official Premium List NIAGARA REGIONAL HERDING CLUB Presents its 93 rd, 94 th 95 th 96 th 97 th and 98 th CKC HERDING TRIALS May 10 and 11, 2014 To be held at Tee Creek 12195 Willodell Rd. Niagara Falls, Ontario Offering the following Saturday, May 10, 2014 2 Stockdog Trials on sheep SDS, SDI, SDA (Entry limited to 6 runs each trial) Sunday, May 11, 2014-2 Arena Trials on sheep HT, HS, HI, HA AND - 2 Arena Trials on ducks HT, HS, HI, HA (Entry limited to 40 runs all classes) There will not be a class for HTT at these trials Limited Entry For Exhibition Only entries will be accepted, subject to available space Entries Close on Friday, April 25, 2014 at 8:00 pm DAY OF TRIAL ENTRIES WILL BE ACCEPTED, SUBJECT TO AVAILABLE SPACE, UP TO ONE HOUR BEFORE EACH TRIAL Entries will close on Friday, April 25, 2014 at 8:00 pm or when the limit of 6 stockdog runs (for each of the stockdog trials) or 40 arena runs (for the arena trials), has been reached. Entries will be accepted on a first come, first served basis. These trials will be held outdoors - Rain or shine The trials are sponsored in part by Pawsitive Play please visit their booth! These trials held under the rules of the Canadian Kennel Club
NIAGARA REGIONAL HERDING CLUB OFFICERS - 2014 President Vice-President Secretary Treasurer Dave Harris Terry Arbuckle Susan Fast Kathy Warner Herding Trial Committee Trial Chairman Chief Stock Handler Course Director Trial Secretary Dave Harris Kathy Warner Dave Harris Sue Neave 1355 Line 9, RR 1 Niagara-on-the-Lake, Ontario L0S 1J0 E-mail: sueneave@sympatico.ca Phone: (905) 262-4086 ALL PHONE CALLS WILL BE RETURNED COLLECT JUDGES: Stockdog Trial #1 Sat., May 10 Stockdog Trial #2 Sat., May 10 Ron Forbes Heather Forbes 642960 Rd. 64, RR 3 642960 Rd. 64, RR 3 Ingersoll, ON N5C 3J6 Ingersoll, ON N5C 3J6 Arena Trials Sunday, May 11 Duck Trial #1 & Sheep Trial #1 Duck Trial #2 & Sheep Trial #2 Ron Forbes Heather Forbes 642960 Rd. 64, RR 3 642960 Rd. 64, RR 3 Ingersoll, ON N5C 3J6 Ingersoll, ON N5C 3J6
CANADIAN ONTARIO CKC KENNEL CLUB CENTRAL DIRECTOR HERDING REP Nancy Carey, Executive Director Alan Ewles Irene Latchford 200 Ronson Dr., Suite 400, 1231 20 th Sideroad, 589 Eight Road E Etobicoke, Ontario RR 1, Moffat, ON Stoney Creek, ON M9W 5Z9 L0P 1J0 L8J 2X4 ENTRY INFORMATION PLEASE NOTE: These are limited Trials. Entry fee is $45.00 for each Arena class entered and $50.00 for each Stockdog class entered. Day of Trial entries will be $55.00 and $60.00 respectively. Entries will close on Friday, April 25, 2014 at 8:00 pm or when the limit of 40 arena runs (for the arena trials), or 6 stockdog runs (for each stockdog trial) has been reached. Entries will be accepted on a first come, first served basis. When the advertised limit has been reached, all remaining entries will be assigned a position on the alternate list to be drawn up in the same order as they are received. The person making the entry shall be notified of his/her position on the list. In the event any dog is pulled after the closing date, it may be substituted with one from the alternate list up to and including the day of the trial. Entry fees will be refunded within 10 days following the trial for those on the alternate list who did not participate in the trial. RUN ORDER: The draw for run order will take place at the home of the Trial Secretary on Saturday, April 26, 2014 at or before 8:00 p.m. At that time, the Trial Secretary will no longer wait for entries delayed in the mail, regardless of the date posted. BITCHES IN SEASON: Are allowed to compete ENTRY REQUIREMENTS: All dogs must be at least 6 months of age. CKC Miscellaneous Breeds cannot enter CKC events unless they have a Miscellaneous number. CKC RULES: Rule books can be obtained from the CKC by calling their Order desk at: 1-800-250-8040 ENTRY FEES: - $45.00 for each Arena Class $50.00 for each Stockdog Class (prior to closing) $55.00 for each Arena Class $60.00 for each Stockdog Class (day of trial) Please make cheques payable to: "Niagara Regional Herding Club" and send your entries to: Sue Neave, Herding Trial Secretary, 1355 Line 9, RR 1, Niagara-on-the-Lake, Ontario L0S 1J0 Phone: (905) 262-4086 E-mail: sueneave@sympatico.ca ATTENTION US EXHIBITORS: Please note that fees are due and payable in Canadian Dollars. Due to consistently fluctuating currency rates, discounted cheques will not be accepted. Personal cheques will be accepted, however; they are to be payable in Canadian funds.
Please do no mark cheques "Payable in Canadian Funds" or "At Par". They will not be cleared by the banks and we will not accept them as an entry. To simplify the process we urge you to purchase a bank draft or money order payable in Canadian funds. Your understanding and co-operation is appreciated. Thank you. No entry will be accepted unless accompanied by the appropriate fee. Phone or fax entries will not be accepted. If you have any questions, please contact the Trial Secretary Prizes will be offered by Tee Creek Dog Training Inc. AND by Pawsitive Play (www.pawsitiveplay.com) AWARDS OFFERED: ROSETTES OFFERED : High In Trial - Each Arena Trial Sheep High In Trial - Each Arena Trial Ducks High In Trial Each Stockdog Trial Reserve High In Trial - Each Arena Trial Sheep Reserve High In Trial - Each Arena Trial Ducks Reserve High In Trial Each Stockdog Trial High In Trial - Each Arena Trial Sheep High In Trial - Each Arena Trial Ducks High In Trial Each Stockdog Trial Reserve High In Trial - Each Arena Trial Sheep Reserve High In Trial - Each Arena Trial Ducks Reserve High In Trial Each Stockdog Trial 1 st - 4 th in HS, HI, HA - Each trial sheep &ducks All Herding Tested Qualifiers Dark Green Ribbons will be given for all qualifying scores in Trial classes. All rosettes and prizes will be awarded for qualifying scores only. All awards and Rosettes must be picked up on the day of the trial - none will be mailed. RULES 1. We will use care and diligence for the welfare of all dogs and exhibitors, but will not be responsible for, nor assume liability in the event of an accident or misfortune, however caused, to dogs, exhibitors or property. 2. Dogs must be kept under control at all times, and must be kept on leash or crated, at all times except when competing. 3. The CKC shall not be responsible to any member, person, partnership, club or corporation for any loss, damage or injury arising at or by reason of any trial held under CKC rules. 4. Exhibitors will be responsible for picking up after their dogs. 5. There is limited shade. Exhibitors are advised to bring their own shade, crates, etc.
6. Exhibitors must read and sign the waiver form before being allowed to compete. 7. Events will be held rain or shine. Dress for the weather. 8. Lunch will be available for sale. 9. Exhibitors are solely responsible for the conduct or actions of their dogs while they are on the trial grounds. All dogs must be kept on leash or in crates except when competing. 10. DO NOT go into any areas that are marked with DO NOT ENTER signs or caution tape. This is a farm and there are areas that are off limits for your safety as well as the safety of our farm animals. 11. The precincts of the trial will be the trial arenas and 20 feet around the trial arenas. CKC Regulation 15.7 reads: It shall be the duty and obligation of the trial-giving club to see that a judge, club official, ring steward, volunteer or competitor at a Herding Trial held under these regulations, is not subject to indignities of any kind. The Herding Trial Committee Chair shall promptly report to the CKC any infringement of this regulation, and the Discipline Committee shall have the authority to take such action as it deems fit on receipt of a report indicating that this has occurred. A copy of this regulation shall be prominently placed in every premium list and catalogue. CKC Regulation 18.1 reads: The CKC shall not be responsible to any member, person, partnership, club or corporation for any loss, damage or injury arising at or by reason of any herding trial held under any rules adopted by the CKC. Non-Member Participation Fee 24-12-3. Non-member participation fee a)an annual non-member participation fee for awards and titles will be charged to a Canadian non-member of CKC. The fee will match the ERN fee. b)in order to protect the awards/titles earned, the non-member will have a choice either to become a CKC member or to pay the non-member participation fee. Failure to comply within 30 days of notification will cause all awards and titles to be canceled. c)the Premium List must carry a note stating that these fees apply only to dogs wholly owned by non-ckc members and are not applicable to CKC members. FROM TORONTO: DIRECTIONS TO TEE CREEK Take QEW Fort Erie thru Niagara Falls. After McLeod Rd. the next exit is Lyons Creek Road, take the West exit (go right) onto Lyons Creek Rd. Just as you are speeding
up, there is a road on your left, (in other words make a right and then a quick left) onto Willodell Road. You are almost there! Go down Willodell Rd. approximately 2 miles. After you cross over Schisler Rd. (still on Willodell), we are the second place on the right. There is a large cover-all building up on the hill. Take the 2 nd driveway or last driveway past the house, going back to the training center. FROM BUFFALO: Take the QEW Niagara from the Peace Bridge. Take the Lyons Creek exit off of QEW. At the stop sign, turn left onto Lyons Creek Rd. Just over the overpass there is a road on your left. This is Willodell Rd. Turn LEFT onto Willodell. You are almost there! Go down Willodell Rd. approximately 2 miles. After you cross over Schisler Rd., (still on Willodell) we are the 2 nd place on your right. Take the last driveway past the house and follow the driveway back to the training center. HOTELS and CAMPGROUND THAT WILL ACCEPT DOGS Best Western Fallsview, Comfort Inn, Hipwell s Motel Campground 6289 Fallsview Blvd. 870 Niagara St., 299 Hwy #20 West KOA Niagara Falls Niagara Falls, Ont. Welland, Ont. Fonthill, Ont. 8625 Lundy s Lane (800) 263-2580* (905) 732-4811 (905) 892-3588 Niagara Falls, Ont (800) KOA-6478 Please reconfirm that the hotel accepts dogs when making your reservation, as policies can change without notice. Dogs must be crated when in the hotels. It is becoming increasingly difficult to find hotels that will accept dogs, so please clean up after your dogs and do not leave them in the hotel alone, if they will bark. We want to be able to use these hotels again in the future, so please treat the hotels as if they were your homes. VETERINARIAN After Hours Emergency Clinic Main West Animal Hospital Niagara Veterinary Emergency Clinic 1 Broadway 2F Tremont Dr., Unit #1, Niagara Falls, Ontario St. Catharines, Ontario (905) 735-7877 (905) 641-3185 1-800-465-1414 SATURDAY NIGHT DINNER We will be making arrangements for a group dinner at the Mandarin Restaurant in Niagara Falls (approximately 10 minutes drive from Tee Creek) on Saturday evening about an hour after completion of the stockdog trials. If you wish to join the group, please advise the Trial Secretary by e- mail sueneave@sympatico.ca or add a note when you send in your entries so we can reserve a suitable number of tables.
OFFICIAL CKC ENTRY FORM (Herding Trial) MAY 11, 2014 Arena Trials 94 (ducks) 95 (ducks) 96 (sheep) 97 (sheep) Entry fees $45.00 CDN per class. A listing fee of $9.55 per entry is payable if the dog is not CKC registered. Make cheques payable to Niagara Regional Herding Club, and send to: Sue Neave, Trial Secretary Entries close April 25, 2014 or when entry limits 1355 Line 9, RR 1, are reached. Niagara on the Lake, ON L0S 1J0 905 262 4086 sueneave@sympatico.ca Name of Club: Niagara Regional Herding Club EVENT INFORMATION FEES: Entry fee $ Listing Fee $ Total Enclosed $ CLASSES ARENA STOCKDOG TENDING TRIAL 95 TRIAL 96 TRIAL 97 TRIAL 98 DOG INFORMATION Registered Name of Dog Call Name Breed Male Female CKC Registration # CKC Miscellaneous # CKC ERN # Listed CKC PEN # dd mm yy Date of Birth Place of Birth Canada Elsewhere Breeder: Insert Number Here: Sire Dam OWNER(S) & AGENT INFORMATION Registered Owner(s) Handler Owner s Address Name of Agent (if any) Agent s Address Street Address City Prov. Postal Code I CERTIFY that I am the registered owner(s) of the dog or that I am the authorized agent of the actual owner(s) whose name(s) I have entered above and accept full responsibility for all statements made in this entry. In consideration of the acceptance of this entry, I (we) agree to be bound by the rules and regulations of The Canadian Kennel Club and by any additional rules and regulations appearing in the premium list. ( ) Signature of Owner or Agent Telephone Number Email
RELEASE/WAIVER AGREEMENT In consideration for participation in these events sanctioned by the Canadian Kennel Club (CKC), I agree to assume all responsibility for any claim, loss or damage, of whatever kind or nature, whether to person or property, which may be caused at or near this event, either directly or indirectly, by me or the dog or dogs I have entered in or brought to this event. I further agree that I will hold the CKC, its officers, directors, agents and members, the trial giving club, its officers, directors, agents and members and the owners of the facility and the stock, harmless and defend them from any and all liability for any injury, claim, damage or loss, of whatever kind or nature, whether to person or property, caused at or near this event, whether directly or indirectly, by or to me or any dog I have entered in or brought to this event. I agree to indemnify the CKC, its officers, directors, agents and members, the trial giving club, its officers, directors, agents and members and the owners of the trial facility and the stock, and any volunteers, for any loss, cost or expense including attorneys fees and costs, to which the CKC, its officers, directors, agents or members, the trial giving club, its officers, directors, agents and members and the owners of the facility and the stock and volunteers, might be subject to as a result of any claim, suit, loss or damage caused in any way by any act or negligence on my part or on the part of any dog or dogs I have entered in or brought to the event. I acknowledge that while the CKC may provide sanctioning for this event, it does not have and does not exercise control over the conduct of the event or those present. I certify and represent that the dog or dogs I have entered in or brought to this event is/are not a hazard to other dogs, other animals, or to people. I also agree to pay the full market value of any livestock death ($200.00 Cdn. for sheep and $20.00 Cdn. for ducks), resulting from my dog's actions, whether willful or accidental, or in the case of injury to any livestock, resulting from my dog's actions, I agree to pay all veterinary fees up to the market value of the animal. I agree to pay for repair and/or replacement of damaged equipment or property (based on the cost of parts plus labour based on minimum wage as established by the Province of Ontario) resulting from my dog s actions, whether willful or accidental. Owner or Agent making entry (Please print) Signature Date Dog's Full Name: Phone E-mail ONLY ONE DOG PER ENTRY FORM.
OFFICIAL CKC ENTRY FORM (Herding Trial) MAY 10, 2014 Stockdog Trial 93 & 94 (sheep) Entry fees $50.00 CDN per class. A listing fee of $9.55 per entry is payable if the dog is not CKC registered. Make cheques payable to Niagara Regional Herding Club, and send to: Sue Neave, Trial Secretary Entries close April 25, 2014 or when entry limits 1355 Line 9, RR 1, are reached. Niagara on the Lake, ON L0S 1J0 905 262 4086 sueneave@sympatico.ca Name of Club: Niagara Regional Herding Club EVENT INFORMATION FEES: Entry fee $ Listing Fee $ Total Enclosed $ CLASSES ARENA STOCKDOG TENDING TRIAL 93 DATE MAY 10, 2014 TRIAL 94 DATE MAY 10, 2014 DOG INFORMATION Registered Name of Dog Call Name Breed Male Female CKC Registration # CKC Miscellaneous # CKC ERN # Listed CKC PEN # dd mm yy Date of Birth Place of Birth Canada Elsewhere Breeder: Insert Number Here: Sire Dam OWNER(S) & AGENT INFORMATION Registered Owner(s) Handler Owner s Address Name of Agent (if any) Agent s Address Street Address City Prov. Postal Code I CERTIFY that I am the registered owner(s) of the dog or that I am the authorized agent of the actual owner(s) whose name(s) I have entered above and accept full responsibility for all statements made in this entry. In consideration of the acceptance of this entry, I (we) agree to be bound by the rules and regulations of The Canadian Kennel Club and by any additional rules and regulations appearing in the premium list. ( ) Signature of Owner or Agent Telephone Number Email
RELEASE/WAIVER AGREEMENT In consideration for participation in these events sanctioned by the Canadian Kennel Club (CKC), I agree to assume all responsibility for any claim, loss or damage, of whatever kind or nature, whether to person or property, which may be caused at or near this event, either directly or indirectly, by me or the dog or dogs I have entered in or brought to this event. I further agree that I will hold the CKC, its officers, directors, agents and members, the trial giving club, its officers, directors, agents and members and the owners of the facility and the stock, harmless and defend them from any and all liability for any injury, claim, damage or loss, of whatever kind or nature, whether to person or property, caused at or near this event, whether directly or indirectly, by or to me or any dog I have entered in or brought to this event. I agree to indemnify the CKC, its officers, directors, agents and members, the trial giving club, its officers, directors, agents and members and the owners of the trial facility and the stock, and any volunteers, for any loss, cost or expense including attorneys fees and costs, to which the CKC, its officers, directors, agents or members, the trial giving club, its officers, directors, agents and members and the owners of the facility and the stock and volunteers, might be subject to as a result of any claim, suit, loss or damage caused in any way by any act or negligence on my part or on the part of any dog or dogs I have entered in or brought to the event. I acknowledge that while the CKC may provide sanctioning for this event, it does not have and does not exercise control over the conduct of the event or those present. I certify and represent that the dog or dogs I have entered in or brought to this event is/are not a hazard to other dogs, other animals, or to people. I also agree to pay the full market value of any livestock death ($200.00 Cdn. for sheep and $20.00 Cdn. for ducks), resulting from my dog's actions, whether willful or accidental, or in the case of injury to any livestock, resulting from my dog's actions, I agree to pay all veterinary fees up to the market value of the animal. I agree to pay for repair and/or replacement of damaged equipment or property (based on the cost of parts plus labour based on minimum wage as established by the Province of Ontario) resulting from my dog s actions, whether willful or accidental. Owner or Agent making entry (Please print) Signature Date Dog's Full Name: Phone E-mail ONLY ONE DOG PER ENTRY FORM.
OFFICIAL CKC ENTRY FORM (Herding Trial) MAY 11, 2014 Arena Trials 94 (ducks) 95 (ducks) 96 (sheep) 97 (sheep) Entry fees $45.00 CDN per class. A listing fee of $9.55 per entry is payable if the dog is not CKC registered. Make cheques payable to Niagara Regional Herding Club, and send to: Sue Neave, Trial Secretary Entries close April 25, 2014 or when entry limits 1355 Line 9, RR 1, are reached. Niagara on the Lake, ON L0S 1J0 905 262 4086 sueneave@sympatico.ca Name of Club: Niagara Regional Herding Club EVENT INFORMATION FEES: Entry fee $ Listing Fee $ Total Enclosed $ CLASSES ARENA STOCKDOG TENDING TRIAL 95 TRIAL 96 TRIAL 97 TRIAL 98 DOG INFORMATION Registered Name of Dog Call Name Breed Male Female CKC Registration # CKC Miscellaneous # CKC ERN # Listed CKC PEN # dd mm yy Date of Birth Place of Birth Canada Elsewhere Breeder: Insert Number Here: Sire Dam OWNER(S) & AGENT INFORMATION Registered Owner(s) Handler Owner s Address Name of Agent (if any) Agent s Address Street Address City Prov. Postal Code I CERTIFY that I am the registered owner(s) of the dog or that I am the authorized agent of the actual owner(s) whose name(s) I have entered above and accept full responsibility for all statements made in this entry. In consideration of the acceptance of this entry, I (we) agree to be bound by the rules and regulations of The Canadian Kennel Club and by any additional rules and regulations appearing in the premium list. ( ) Signature of Owner or Agent Telephone Number Email
RELEASE/WAIVER AGREEMENT In consideration for participation in these events sanctioned by the Canadian Kennel Club (CKC), I agree to assume all responsibility for any claim, loss or damage, of whatever kind or nature, whether to person or property, which may be caused at or near this event, either directly or indirectly, by me or the dog or dogs I have entered in or brought to this event. I further agree that I will hold the CKC, its officers, directors, agents and members, the trial giving club, its officers, directors, agents and members and the owners of the facility and the stock, harmless and defend them from any and all liability for any injury, claim, damage or loss, of whatever kind or nature, whether to person or property, caused at or near this event, whether directly or indirectly, by or to me or any dog I have entered in or brought to this event. I agree to indemnify the CKC, its officers, directors, agents and members, the trial giving club, its officers, directors, agents and members and the owners of the trial facility and the stock, and any volunteers, for any loss, cost or expense including attorneys fees and costs, to which the CKC, its officers, directors, agents or members, the trial giving club, its officers, directors, agents and members and the owners of the facility and the stock and volunteers, might be subject to as a result of any claim, suit, loss or damage caused in any way by any act or negligence on my part or on the part of any dog or dogs I have entered in or brought to the event. I acknowledge that while the CKC may provide sanctioning for this event, it does not have and does not exercise control over the conduct of the event or those present. I certify and represent that the dog or dogs I have entered in or brought to this event is/are not a hazard to other dogs, other animals, or to people. I also agree to pay the full market value of any livestock death ($200.00 Cdn. for sheep and $20.00 Cdn. for ducks), resulting from my dog's actions, whether willful or accidental, or in the case of injury to any livestock, resulting from my dog's actions, I agree to pay all veterinary fees up to the market value of the animal. I agree to pay for repair and/or replacement of damaged equipment or property (based on the cost of parts plus labour based on minimum wage as established by the Province of Ontario) resulting from my dog s actions, whether willful or accidental. Owner or Agent making entry (Please print) Signature Date Dog's Full Name: Phone E-mail ONLY ONE DOG PER ENTRY FORM.
OFFICIAL CKC ENTRY FORM (Herding Trial) MAY 10, 2014 Stockdog Trial 93 & 94 (sheep) Entry fees $50.00 CDN per class. A listing fee of $9.55 per entry is payable if the dog is not CKC registered. Make cheques payable to Niagara Regional Herding Club, and send to: Sue Neave, Trial Secretary Entries close April 25, 2014 or when entry limits 1355 Line 9, RR 1, are reached. Niagara on the Lake, ON L0S 1J0 905 262 4086 sueneave@sympatico.ca Name of Club: Niagara Regional Herding Club EVENT INFORMATION FEES: Entry fee $ Listing Fee $ Total Enclosed $ CLASSES ARENA STOCKDOG TENDING TRIAL 93 DATE MAY 10, 2014 TRIAL 94 DATE MAY 10, 2014 DOG INFORMATION Registered Name of Dog Call Name Breed Male Female CKC Registration # CKC Miscellaneous # CKC ERN # Listed CKC PEN # dd mm yy Date of Birth Place of Birth Canada Elsewhere Breeder: Insert Number Here: Sire Dam OWNER(S) & AGENT INFORMATION Registered Owner(s) Handler Owner s Address Name of Agent (if any) Agent s Address Street Address City Prov. Postal Code I CERTIFY that I am the registered owner(s) of the dog or that I am the authorized agent of the actual owner(s) whose name(s) I have entered above and accept full responsibility for all statements made in this entry. In consideration of the acceptance of this entry, I (we) agree to be bound by the rules and regulations of The Canadian Kennel Club and by any additional rules and regulations appearing in the premium list. ( ) Signature of Owner or Agent Telephone Number Email
RELEASE/WAIVER AGREEMENT In consideration for participation in these events sanctioned by the Canadian Kennel Club (CKC), I agree to assume all responsibility for any claim, loss or damage, of whatever kind or nature, whether to person or property, which may be caused at or near this event, either directly or indirectly, by me or the dog or dogs I have entered in or brought to this event. I further agree that I will hold the CKC, its officers, directors, agents and members, the trial giving club, its officers, directors, agents and members and the owners of the facility and the stock, harmless and defend them from any and all liability for any injury, claim, damage or loss, of whatever kind or nature, whether to person or property, caused at or near this event, whether directly or indirectly, by or to me or any dog I have entered in or brought to this event. I agree to indemnify the CKC, its officers, directors, agents and members, the trial giving club, its officers, directors, agents and members and the owners of the trial facility and the stock, and any volunteers, for any loss, cost or expense including attorneys fees and costs, to which the CKC, its officers, directors, agents or members, the trial giving club, its officers, directors, agents and members and the owners of the facility and the stock and volunteers, might be subject to as a result of any claim, suit, loss or damage caused in any way by any act or negligence on my part or on the part of any dog or dogs I have entered in or brought to the event. I acknowledge that while the CKC may provide sanctioning for this event, it does not have and does not exercise control over the conduct of the event or those present. I certify and represent that the dog or dogs I have entered in or brought to this event is/are not a hazard to other dogs, other animals, or to people. I also agree to pay the full market value of any livestock death ($200.00 Cdn. for sheep and $20.00 Cdn. for ducks), resulting from my dog's actions, whether willful or accidental, or in the case of injury to any livestock, resulting from my dog's actions, I agree to pay all veterinary fees up to the market value of the animal. I agree to pay for repair and/or replacement of damaged equipment or property (based on the cost of parts plus labour based on minimum wage as established by the Province of Ontario) resulting from my dog s actions, whether willful or accidental. Owner or Agent making entry (Please print) Signature Date Dog's Full Name: Phone E-mail ONLY ONE DOG PER ENTRY FORM.