V A L

Valencia Valley Kennel Club
VALENCIA VALLEY KENNEL CLUB
Nancy Culley, Trial Secretary
P.O. Box 327
Bosque, NM 87006
*
PREMIUM LIST©- All Breed AKC Agility Trial
This Event is Accepting Entries for Dogs Listed in the
AKC Canine Partners Program
Licensed by the American Kennel Club
Friday, Oct 24 2014 Event #2014496401
Saturday,Oct 25, 2014 Event #2013496402
Sunday, April 26, 2014 Event #2014496403
EAGLE PARK SOCCER FIELDS
305 Eagle Lane, Belen, NM 87002
Ring size 100’x 100’ -2 Alternating Rings
Show Site Hours: 6:30am - 7:00pm
JUDGE
Blair Kelly
1309 Beltram, Odenton, MD 21113
JUDGING ALL CLASSES / ALL DAYS
MAIL ENTRIES WITH FEES PAYABLE TO VVKC TO;
Nancy Culley, VVKC
P.O. Box 327, Bosque, NM 87006
Ph (505) 861-5985
[email protected]
st
1 Class and Priority Mail ONLY-No Hand delivered----No Express mail
No Online Entries
OPENING DATE FOR ENTRIES:
Sept 10, 2014 Noon- MDST
CLOSING DATE* FOR ENTRIES:
Oct 10, 2014 Noon –MDST
Received date not postmarked date
Entry Fees;
$18 Per run/day/dog (includes $3.50 AKC recording feefirst run and $3.00 recording fee for addition runs)
Method of Entry: First ReceivedEntry -Limit 330 runs per
day.
ALL THREE DAYS
Offering Time 2 Beat, JWW, and Standard Titling
Classes Regular and Preferred- All Levels
CERTIFICATION
Permission has been granted by the
American Kennel Club for the holding of this
event under American Kennel Club Rules
and Regulations
James P Crowley, Secretary
OFFICERS OF THE CLUB
President……Charles Orrie
Vice President…..Faye Mitchell
Secretary….Dora Jacobs, 5160 Cedro Way SW, Los Lunas, NM 87031
Treasurer……Barbara Fitzgerald
Board of Directors: Terry Culley, Adelicia Orrie, and JoAnn Tennnison
Agility Trial Committee (Event Committee)
Trial Chairperson……………………….….Terry Culley 505-861-5985
P.O. Box 327, Bosque, NM 87002
Nancy Culley, Dora Jacobs, Joann Tennison, Charles Orrie As well as all
active members of the Valencia Valley Kennel Club Of New Mexico who are
present.
VETERINARIAN ON CALL:
Friday - Daytime
Valencia Animal Clinic
(505) 8644075
1533 E River Rd, Belen, NM
87002
AVMA STATEMENT
Exhibitors should follow their veterinarians
recommendations to assure their dogs are free of
internal and external parasites, any communicable
diseases and have appropriate vaccinations. You
should always have a copy of your rabies vac.
Certificate with you when you travel with your dog
Evenings and Weekends
PET ER 565-3737
355 HIGHWAY 314
LOS LUNAS, NM 87031
TRIAL SITE HOURS –RUNNING ORDER
FRIDAY: 6:30am - 7:00pm- Judging Begins at 8:00 am- Alternating Rings
Time 2 Beat , Excellent Jumpers, Excellent Standard, Open Jumpers, Open
Standard, Novice Jumpers, Novice Standard--- SMALL TO TALL
SATURDAY 6:30am- 7:00pm- Judging Begins at 8:00am –Alternating Rings—
Time 2 Beat , Excellent Jumpers, Excellent Standard, Open Jumpers, Open
Standard, Novice Jumpers, Novice Standard--- TALL TO SMALL
SUNDAY 6:30am- 7:00pm- Judging Begins at 8:00am –Alternating Rings—
Time 2 Beat , Excellent Jumpers, Excellent Standard, Open Jumpers, Open
Standard, Novice Jumpers, Novice Standard--- SMALL TO TALL
CLASS INFORMATION, JUMP HEIGHTS , SCORING :Classes offered: Regular Titling; Novice A
& B. Open, Excellent/Master for Standard and JWW. Preferred: Novice, Open, Excellent/Master
for Standard and JWW . Owners are responsible for entering the proper class and height All
exhibitors should obtain a copy of the Regulations for Agility Trials by downloading from the
American Kennel Club Website http://www.akc.org/rules/
Obstacles will conform to the current edition of the AKC Regulations for Agility Trials effective Jan
1, 1214
COURSE FAMILIARIZATION/ WARM-UPS: Handlers in all classes are permitted to walk the
course without a dog prior to the start of class. The walk through is restricted to handlers entered in
the class. Walk thrus for the excellent/Master class will be divided by Small (4”-16”) and Tall
(20”-26”) and will be Walk –Run/Walk –Run In the order the trail is being run for the day A warm
up jump will be provided for each ring.
MOTEL ACCOMODATIONS
Belen
SUPER 8 MOTEL- 428 South Main Street , Belen NM 87002-- ONLY 5 MINUTES
FROM SHOW SITE. . Call the motel directly for the discounted rate and tell them you
are coming for the VVKC Dog Show to receive this special offer. Special Pet Fee for
exhibitors
Phone: 505-864-8188
****We almost lost this facility due to dog feces being left in several rooms.
Anyone not cleaning up after their dogs will be subject to disciplinary action to its
fullest. Do not leave dogs unattended in your room
Los Lunas (10 miles north)
DAYS INN- 1919 Main, Los Lunas, NM 87031-(Just off I-25 in Las Lunas)
Phone 505-865-5995 to check for rates and Pet Policy
Western Skies Inn- 2258 Sun Ranch Village Loop, Las Luna, NM 87031 (Just off I-25 in
Las Lunas) Ph 505-865-0001 to check for rates and Pet Policy
Albuquerque (35 miles north)
Motel 6- Airport- 1000 Avenida Cesar Chavez, Albuquerque, NM 87102. About 30
minutes to show site. Contact motel regarding pet policy PH 505-243-8017
Valencia Valley Kennel Club makes no guarantee that these motel policies will be the
same on the dates of the trial. When traveling with a pet, you should always recheck the
pet policy.
You must clean up after your dogs, both outside and inside, do not leave them
unattended in the motel room, dogs are to be quiet and under control, in crates, and
please obey the individual motel rules regarding dogs.
RV PARKING
RV parking will be available at the show site starting on Thursday April4- however there
are no hookups of any kind. RV’s must be self contained. No reservations are required.
DIRECTIONS TO SHOW SITE: Traveling North or South on I-25 Exit at Camino del
Llano (Exit 191) Turn East toward the mountains and go(point 5 miles) to Mesa Road.
Turn left on Mesa (North) and proceed to (point 4 miles) Delgado- Turn West (left) on
Delgado and go to(point 2 miles) Eagle Lane--Turn onto Eagle lane heading North
(right) - Do not go into the High School security area--- Eagle lane will curve to the west
and the Soccer Fields are to your left. Stay on Eagle lane to reach the parking area
ABOUT THE SITE: Outdoors on grass- (Rings will be enclosed with gates) with ample
crating space around the ring. The Practice jump will be enclosed with gate.. There is
no Off Leash area at this site except for in the ring and the practice jump. Bring
your own shade and water. A food vendor will be at the site for breakfast and lunch .
st
th
AWARDS: Strip ribbons will be awarded to the 1 -4 place dog in each jump height in
each class. The placement ribbons will conform with the colors set by AKC. Green
Qualifying strip ribbons will be awarded to all dogs receiving qualifying scores. Rosettes
will be awarded for those finishing a title. MACH Rosette and Brass Medallion will be
presented to handlers finishing a MACH/PACH/PAX title during the event. Bars will also
be awarded for MACH/PACH/PAX Title. All prizes and awards must be claimed the day
of the trial. No prize/award will be mailed.
VENDORS ARE WELCOME- Please contact Terry Culley at
[email protected]
to reserve a space.
NOTICE TO EXHIBITORS
SAFETY, BEHAVIOR , LIABILITY: Members of the Valencia Valley Kennel Club, and their agents,
assume no responsibility for any loss, damage, or injury sustained by exhibitors, handlers, or their
dogs, or property and further assume no responsibility for injury to children and guests.
VVKC may decline any entries for cause and may refuse to receive or may remove any dog on
account of disease, viciousness or other cause, and no one shall have any claim or recourse
against VVKC or any official thereof.
Safety of the dogs is our primary concern. By entering this event, exhibitors acknowledge that
they are familiar with the rules and regulations of the sport, and that their dogs are familiar with and
are able to perform all of the obstacles safely.
All dogs must be on a leash at all times except when in the ring or when in the designated warm up
area. It is expressly understood that the exhibitors alone are responsible for the behavior of their
dog(s) guest(s) and /or children. Those engaging in unsafe or disruptive behavior may, at the
discretion of the trial committee, be asked to leave the site. In such cases there will be no refund of
fees paid.
In consideration of others you will be expected to clean up after yourself and your dogs at the event
site and at your motel. Failure to do so may be cause for dismissal.
ELIGIBILITY: This event is open to all dogs fifteen (15) months of age or older that are registered
with the American Kennel Club or that have Limited Registration, Indefinite Listing Privileges (ILP)
PAL Number, Mixed Breeds that have a Canine Partner Listing number (CPL) or Approved FSS
Breeds, with the exception of bitches in season, aggressive dogs, dogs suffering from any
deformity, injury or illness which may affect the dogs’ physical or mental performance. For a
complete description of other physical disqualifications please refer to Chapter 1, Sec 3. For the
listing of registerable breeds that may participate refer to Chapter 2 of the Registration and
Discipline Rules
REFUNDS: Entry fees will not be refunded in the event that a dog is absent, disqualified, excused,
barred from competition by action of the Event Committee. No entry fees will be refunded for dogs
withdrawn after the closing date except for bitches who come into season or any dogs who are
withdrawn due to a change of judge(s), , providing the Event Secretary receives notice in writing
at the beginning of the day.of the trial . No entry fees will be refunded if the event cannot open or be
completed by reason of riots, civil disturbances, fire, violent acts of nature, public emergency, or
any other cause beyond the control of the event committee.
All regulations governing the use of this facility and all regulations and decisions of the event
committee will be strictly enforced, including and not limited to the recorded information of this
premium list.
Faxed, telephoned, or unsigned, or incomplete entries cannot be accepted. Entries not on the
current official AKC entry forms and photocopies of entry forms without the agreement and rules on
the reverse side of the official AKC entry form are not acceptable No entry shall be made and no
entry shall be accepted which specifies any conditions to its acceptance. A maximum of 10
Entries per envelope is allowed. Envelopes with more than the 10 dog maximum shall be treated
as an invalid entry and shall be returned to the sender. Returned checks do not constitute a valid
entry fee and are subject to an added collection fee
Changes, additions, or corrections to entry forms must be received in writing prior to the close of
entries. Those received by telephone are not acceptable.
Entries cannot be accepted, cancelled, altered or substituted after the entries have closed except
as provided for in chapter 11, section 6 of the Rules Applying to Dog Shows. Owners are
responsible for errors in the entry forms, regardless of who may make such errors.
ENTRY RECEIVED NOTICES; All those who send a legible email address will receive notice that
entry has been received- Please
check for errors and report them
immediately!!
If you do not have an email address you may send a self addressed stamped
envelope for entry received verification
CATALOG ORDERS: Catalogs are available on a pre-order basis. Please include $10 fee with
your entry. A limited number will be available for sale at the trial.
Jump Height Card Process
When filling out the entry form, there is a new section at the top of the form for exhibitors to
designate whether your dog has a valid jump height card or if your dog needs to be measured.
Please check the appropriate box so that the Trial Secretary knows whether to include your dog on
the Dogs To Be Measured List. It is no longer required that you submit a copy of your dog’s jump
height card with your entry form or show it during day of show check-in.
If your dog is under the age of two years as of the trial’s date: One (1) temporary measurement
is required. Once measured, be sure to retain the Agility Measurement Form yellow copy and check
NO my dog does not need to be measures, otherwise your dog needs to be measured. If your dog
turns two years of age or is older as of the trial’s date, your temporary measurement expires on
their 2nd birthday and your dog needs to be measured. If your dog is the age of two years or
older as of the trial’s date: A minimum of two (2) permanent measurements are required. If both
permanent measurements place your dog into the same jump height class, the AKC office will issue
you a permanent card. Exception to the 2 permanent measurement requirement: If your dog
measures over 22 inches at the withers, you have the option of selecting the “Over 22” Reqst Perm”
box at the top left corner of the Agility Measurement Form to receive a permanent jump height card
from AKC after a single measurement. If you do so, please also sign below the checkbox.
Third measurement tie breakers and challenge measurement rules can be found in Regulations for
Agility Trials Chapter 2, Section 4. Until such time that you have received all required challenge
measurements, you must continue to compete at the original jump height stated on the permanent
jump height card that is in your possession.
It is the sole responsibility of the exhibitor to have their original, official jump height card or
temporary jump height form at each trial to present upon request. Additionally, if a
measurement is necessary, it is the exhibitor’s responsibility to have their dog measured
prior to running. Regulations for Agility Trials, Chapter 2, Section 4.
REGULAR CLASSES
8”
12”
16”
20”
24”
26”
HEIGHT CLASSES
DOGS ACTUAL HEIGHT
11” and under at the withers
14” and under at the withers
18” and under at the withers
22” and under at the wither
Over 22” at the withers
Dogs may be entered at this height at
the owners discretion
PREFERRED CLASSES
4”
8”
12”
16”
20”
Complete rules can be found on the AKC website at www.akc.org. For
a copy of the rulebook write to American Kennel Club, 8051 Arco
Corporate Dr, Suite 100, Raleigh, NM 27617. To place a credit card
order by telephone call: (919) 233-9767 or email : [email protected]
◄
Map of the Los Lunas-Belen area
Please note it is not to scale.
GO PAST THE BASEBALL FIELDS TO THE
SOCCER FIELDS ON THE LEFT HAND SIDE OF THE ROAD IF
GOING WEST.
VETERINARIAN ON CALL: FRIDAY DAYTIME
VALENCIA ANIMAL CLINIC
1533 E. River Rd., Belen, NM 87002 PHONE (505) -864-4075
VETERINARIAN ON CALL: EVENINGS AND WEEKEND
Pet Er 505-565-3737---355 Highway 314 SW, Los Lunas, NM 87031
Maps from the show site to the Emergency Vet Clinic will be at the
Exhibitors table.
The map of the general Area also shows the location of the Veterinary
Offices.
Listed in this premium
EMERGENCY/ DISASTER PROCEDURES: Our emergency
coordinator will be on the grounds throughout the show. A list of
emergency contacts will be posted and the coordinator will assist you in
reaching whatever help is needed.
FIRE/ POLICE Call 911
Ambulance Service- Living Cross 869-0800
To store your dogs’ entry data and create an
entry form You may use the free service
offered by Oaklines. Visit them at
www.oaklines.com
OFFICIAL AMERICAN KENNEL CLUB
AGILITY TRIAL MOVE UP FORM
(Do not send this form to AKC. Send it to the Trial Secretary)
It is the option of the club to allow day to day move-ups. Exhibitors should refer to the club’s premium list
to verify the club’s policy for moving a dog up. If offered, dogs shall be moved up to a higher class at the
request of the owner, as a result of the dog qualifying for an agility title.
The request for moving up must be made to the Trial Secretary according to the club’s published policy. All
move up entries are subject to availability of the class and payment of any difference in entry fee. Dogs so
moved up will be entered at the end of the running order. Refer to Chapter 1, Section 20 of the Regulations
for Agility Trials for additional move up requirements.
Name.of.Club.you.want..move.up.for_______________________________________Date:_________
Dog’s AKC Registered Name:_____________________________Dog’s AKC#___________________
Breed:__________________________________________Sex:____________
MOVE ENTRY TO: PLEASE CIRCLE ONE:
STANDARD –CIRCLE ONE :
JWW-CIRCLE ONE :
OPEN
OPEN
Regular
EXCELLENT
EXCELLENT
Preferred
JumpHt_________
MASTER
MASTER
Owner (Please Print)_____________________________Handler____________________ ____
(First and last name)
(If other than owner)
Signature of Owner/Agent__________________________________________
Signature of Trial Secretary______________________________________Date/Time__________
Updated 6/1
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
Dogs shall be moved up to a higher class at the request of the owner, as a result of qualifying for an
agility title, provided that the request is made in writing to the Trial secretary not later than 6:00 pm
on the Monday preceding the set of trials Starting on a Thursday –Sunday. For this set of trials the
deadline for pre-trial move ups is Monday preceding event.
▼FOR PRE-TRIAL MOVE UPS: READ INSTRUCTIONS CAREFULLY▼
MAIL IN MOVE UP; Complete the form above and mail to:
Nancy Culley, P.O. Box 327, Bosque, NM 87006
EMAIL MOVE UP: PRE TRIAL ONLY- A “NEW’ EMAIL
SEND TO: [email protected]
ADDRESS EMAIL AS VVKC/MOVE UP
For Your email move up to be valid you MUST include the following
information. (Your confirmation message does not suffice)
1. Dogs Registered Name
2. Dogs Registration Number
3. Class or classes moving to
4. Owners First AND Last Name
Day to day move ups will be allowed provided the request is received in writing no
later than 15 minutes after the last dog of the day has run.
Your help is needed – we can’t do it without
you!!
Listed below are the many ways you can help us make this agility trial a
success
Please let us know which jobs you can help with and Class(es) you would be
willing to work.
You will be rewarded for contributing your time and helping us out.
Please check the job(s) you would like to do.
 Timekeeper: Person who sets the electronic timer to time every dog
running for the entire class.
 Scribe: Person who watches only the judge and marks faults on the
scribe sheet. Records time after the digital time is displayed
 Gate steward: Person who maintains running order of dogs and
keeps dogs moving orderly in and out of the ring
 Ring Steward: Person who adjusts bar heights, resets dropped
bars, straightens chute(s), etc
 Runners: Persons who either take the leash from start to finish line or
takes score sheets from scribe to scorekeeper.
 Course Builder: Person who helps Chief Course Builder build
courses
Please return this Completed Form with Your Entry
Name:___________________________Phone:__________________
e-mail address___________________________________________
Willing to Work
FRI
SAT
SUN
Class(es) for which you are willing to work, NOT entered in
(please circle)
Standard
Jumpers
Exc/Master Small
Exc/Master Small
Time 2 Beat
THANK YOU!
Small dogs (4”-16”)
Exc/Master Tall
Open
Exc/Master Tall
Open
Tall dogs (20”-26”
Novice
Novice
OFFICIAL AMERICAN KENNEL CLUB AGILITENTRY FORM
VALENCIA VALLEY KENNEL CLUB-Oct 24-25-25,2014
Opens Sept 10, 2014 noon: ● Closes: Oct 10, 2014 noon
Day 1:
Day 2:
□
□
□
Day 3:
STD
STD
STD
□
□
□
□ Time 2 Beat
□ Time 2 Beat
□ Time 2 Beat
JWW
JWW
JWW
Daily Entry Fee: $18 per run/per dog/ per day----Make checks payable to: VVKC, Mail to: Nancy Culley/VVKC, PO Box 327, Bosque, NM 87006
IMPORTANT: Carefully read instructions before filling out!
ENTRY FEE ENCLOSED
Choose Either Regular OR Preferred Classes
Circle one jump height, and circle class selections :: Only one selection per class (STD, JWW, FAST, T2B)
REGULAR Classes
PREFERRED Classes
8” 12” 16” 20” 24” 26”
STD Nov A Nov B Open Exc Master
4”
8”
12” 16” 20”
STD NovP OpenP ExcP MasterP
JWW Nov A Nov B Open Exc Master
JWW NovP OpenP ExcP MasterP
FAST Nov A Nov B Open Exc Master
FAST NovP OpenP ExcP MasterP
T2B T2B
International Sweepstakes
This Dog Needs To Be Measured
BREED
□Yes □No
□STD □JWW
Select:
□14” □18” □26”
SEX
HEIGHT AT WITHERS
VARIETY
CALL NAME
AKC® NAME (INCLUDE AKC TITLES ONLY)
AKC® NO
□
Enter Complete Registration #
below
ILP NO.
□
PAL NO.
FOREIGN REG. NO & COUNTRY
BREEDER
DATE OF BIRTH
PLACE OF BIRTH (LIST COUNTRY)
□
AGREEMENT
I (we) agree that the club holding this event has the right to refuse 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 negligence of the aforementioned parties or any of
their employees or 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,
INTREPRETATION 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
T2B T2BP
Non-Regular Classes
AKC Rules, Regulations, Policies and Guidelines are available on the American Kennel Club Website
www.akc.org
□
Handlers may opt to enter in a higher height division for all Regular titling classes, but not in a division lower than their proper
height division. Dogs entered in the Preferred classes must compete at the required jump height and may not compete in a
jump height division higher or lower than their proper height division.
All dogs that have not been officially measured for an Agility Jump Height Card may still compete; however, they must be
measured by a Judge of record, an Agility Field Representative, or a Volunteer Measuring Official, prior to running. If measured
by the Judge of record, that measurement will be valid for this trial or back-to-back trials only. If a measurement is necessary, it
is the exhibitor's responsibility to have their dog(s) measured prior to running.
Dogs listed in the AKC Canine PartnersSM program may be eligible to enter all-breed AKC agility 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.
Junior Handlers should enter their Junior Handler number on the front of this form. Should you not have your Junior Handler
number, it may be obtained from the American Kennel Club (919) 233-9767. If the 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__________________________
ACTUAL OWNERS
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 by any additional rules and regulations appearing in the premium
list for this event, and further agree to be bound by the “Agreement” printed on the reverse side of this entry form. I (we) certify
and represent that the dog entered is not a hazard to persons or other dogs. This entry is submitted for acceptance on the
forgoing representation and agreement. I (we) agree to conduct myself (ourselves) in accordance with all such Rules and
Regulations (including all provisions applying to discipline) and to abide by any decisions made in accord with them.
OWNERS ADDRESS
SIGNATURE of owner or his agent duly authorized to make this entry.
SIRE
DAM
NEW ADDRESS
CITY, STATE ZIP + 4
HANDLER
ENTER JR. HANDLER # if applicable
Exhibitor or owner MUST sign on the signature line beneath the instructions.
SIGN.HERE ___________________________________________________________________ X
Telephone Number: ____________________________
□NewEmail
Email Address:_______________________________________________
In case of emergency contact______________________________Phone__________________