APPLICATION FOR ENTRY (Please read the Schedule thoroughly before filling in this Entry form and signing the acknowledgement below)

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Conformation Entries close 4.30pm MONDAY 15 AUGUST 2016. ENTRIES RECEIVED AFTER, BUT POST MARKED BEFORE THE CLOSING DATE WILL BE ACCEPTED. Please forward Entry forms to: Perth Royal Dog Show Coordinator, PO Box 135, Claremont WA 6910 PERSONAL DETAILS Royal Agricultural Society of WA 2016 - PERTH ROYAL DOG SHOW - CONFORMATION APPLICATION FOR ENTRY (Please read the Schedule thoroughly before filling in this Entry form and signing the acknowledgement below) Are you a current RASWA Member? Yes No Membership No:... Contact Name: (This will be where Tickets and Exhibitor information will be sent) Mr, Mrs, Ms, Miss... First Name: Surname: Contact Address: Suburb: State: Postcode: Telephone:...Fax:... Mobile:...Email:... PAYMENT OF ENTRY FEES Method of Payment for Entry fees: Cheque for $... to be made payable to the Royal Agricultural Society of WA. (Office use only - cheque number ) Please debit my Mastercard Visa for the amount of $... Card Number: / / / Expiry Date: / Name on Card:...Signature... SPECIAL SHOW ENTRY FORM CHAMPIONSHIP SHOW / OPEN SHOW / PARADE OR TRIAL to be held under the Rules and Regulations of the Canine Association of WA (Inc) - To be used for each Dog entered. CONDITIONS OF ENTRY: The Exhibitor (or parent/guardian where under 18 years of age) must sign this Application for entry. 1. I/We certify that the particulars as shown on this Entry form are correct and I have read and agreed to the terms and conditions of entry as detailed in the 2016 Perth Royal Dog Show Schedule, including the liability and indemnity provisions. 2. I/We agree to be bound by the Society s General Show Regulations (refer to the RASWA website www.perthroyalshow.com.au/libraries/publications/2014_general_regulations_of_raswa.pdf or alternatively a copy is available upon request). 3. Permission is hereby granted to the publication of photographs relating to participation in the Competition. SIGNATURE OF EXHIBITOR:... DATE: / / PRIVACY ACT STATEMENT The information provided by the Exhibitor in the Application for Entry is collected and used by the Royal Agricultural Society of Western Australia (RASWA) to organise and conduct Competitions at the 2016 IGA Perth Royal Show. We may publish details such as your Name, Address and Exhibit details in any RASWA publication or communication. Such information may also be made available to, and published by, the media. We will not disclose your information without your consent for any other purpose unless required or authorised by law. You may request access to your personal information and, if necessary, request that our records of that information be corrected by writing to the Chief Executive Officer at the Royal Agricultural Society of Western Australia, PO Box 135, Claremont WA 6910. PAGE 1 OF 6

ACCOUNT DETAILS RASWA has a policy whereby all Prize money is paid by EFT (Electronic Funds Transfer). Your banking details will be kept secure and can only be used by RASWA to credit your bank account. Please complete your account details even if you have provided them previously. In accordance with the rules of the competition, failure to provide your bank details will mean that any Prize money you earn will be forfeited and retained by RASWA. Please complete the following: Account Name. Print clearly the account name as shown on your account records. Do not write the account type (for example savings, cheque or mortgage offset). Include spaces between each word and between initials in the account name. Bank. This is the bank name (for example NAB, ANZ, Commonwealth Bank, etc). BSB No. This six digit number identifies the financial institution. Do not include spaces, dashes or hyphens in the number. Account No. You cannot use an account number with more than nine characters. Do not include spaces in the account number. Prize money cannot be paid via electronic funds transfer (EFT) if the nominated account has restrictions on EFT deposits, is a credit card, or an overseas account. THIS SECTION MUST BE COMPLETED. ACCOUNT NAME: Royal Agricultural Society of WA PRIZE MONEY PAYMENT DETAILS BANK: BSB NO: ACCOUNT NO: GST MANAGEMENT RASWA requires the following information from all Competitors in order to make appropriate payments to those Competitors who win a prize. 1. Is what you are supplying to RASWA done as a private recreational pursuit or hobby? Y N 2. If No to Question 1, what is your ABN? 3. Are you registered for GST? Y N NOTE: It is a condition of entry that this information be forwarded to the Royal Agricultural Society of WA. If you do not complete this section of the form we may be required to withhold 46.5% of your prize payment. Office Use Only Account Details Entered: Date: / / Please tick Please tick PAGE 2 OF 6

ONE (1) BREED ONLY PER ENTRY FORM BREED DETAILS (Please state the Breed of the Dog Exhibits you are applying to enter on this Entry form E.g. Bearded Collie) EXHIBIT DETAILS (Conformation Classes only) IF MORE ENTRY FORMS NEEDED PLEASE COPY. *Sex: M=Male, F=Female or N=Neuter 1 2 3 4 PAYMENT DETAILS CONFORMATION ENTRIES BABY CLASS NO. OF CATALOGUES NO. OF ENTRIES MEMBER NON MEMBER TOTAL X $17.00 $20.00 = $ X $12.00 $12.00 = $ X $ 5.00 $ 5.00 = $ (PLEASE TRANSFER TOTAL AMOUNT TO THE FRONT OF THIS ENTRY FORM) TOTAL $ OFFICIAL SHOW ENTRY FORM CHAMPIONSHIP SHOW / OPEN PARADE OR TRIAL To be held under the Rules and Regulations of The Canine Association of W.A. Inc Royal Agricultural Society of WA (Write name of Club for which entry is made) Date of Fixture 24/09/2016 to 1/10/2016 DECLARATION I hereby apply to enter the foregoing exhibit in terms of and upon the conditions set out in the Association s Regulation, by which I agree to be bound, and I hereby certify to the correctness of the particulars endorsed herein. To the best of my knowledge and belief the dog named herein has been inoculated against distemper, parvo virus and hepatitis and has not been exposed to the risk of any infections or contagious diseases within seven weeks prior to the date of the Show. PAGE 3 OF 6

DEFINITION OF CLASSES: CONFORMATION The age of all dogs is calculated in calendar months from midnight of the day preceding the date of birth to the first day of a Sanctioned Show, Trail or Test. These are the Class numbers for the 2016 IGA Perth Royal Show. CLASS 1 CLASS 3 CLASS 4 CLASS 5 CLASS 9 CLASS 11 Note 1 Note 2 CLASS 12 Baby Puppy Dogs of 3 months and under 6 months of age. Puppy Dogs of 6 months and under 12 months of age. Junior Dogs of 9 months and under 18 months. Intermediate Dogs of 18 months and under 36 months. State Bred Dogs 6 months of age or over whelped in the State or Territory in which is it exhibited. Open All dogs 6 months of age or over, and of a breed or variety recognized by the Australian National Kennel Council. Only winners of Classes 3 (Puppy) to 11 (Open) may compete for Challenge Certificates. The Standard numbering as above for male Classes bitch Classes to be numbered as above with the letter A (e.g. 1A, 3A, etc.). Veteran - separate Classes may be offered for Veterans at fixtures. 7 years and over. Note: A Veteran must be entered and exhibited in at least one ordinary Class before it can compete for a Challenge Certificate or any special prize which is not specifically awarded for the Veteran Class. Neutered Exhibits may compete in Veteran Class. PAGE 4 OF 6

BENCHING REQUEST FORM ONLY THE FIRST BENCHING REQUEST FORM SUBMITTED WILL BE ACTED ON. Each Exhibitor must sign ONE FORM ONLY for each day on which they are exhibiting. DO NOT SIGN OR AUTHORISE MULTIPLE FORMS Benching will be allocated by breed and catalogue order of owner. Large benches will be allocated for large breeds wherever possible. If you have a particular request, please detail the request on this Benching Request form with your entry. Benching requests will not be accepted in any other format. Please use a separate Benching Request form for each day on which you will be exhibiting. Whilst every effort is made to accommodate requests, this is not always possible. CLOSING DATE FOR BENCHING REQUESTS: All requests must be received and in hand by close of business at 4.30pm on Monday 15 August 2016. Late requests will not be accepted. DATE OF JUDGING: / / The following people and/or breeds wish to be benched next to each other: PLEASE SEE OVER THE PAGE FOR THE PAVILION PLAN PAGE 5 OF 6

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