1. pets
2. dogs

Premium List
Event #s- Saturday (#2015178401), Sunday (#2015178402)
K-9 Obedience Training
Club
of Menomonee Falls,
Falls, Wisconsin
AKC All-Breed Agility Trial
(Licensed by the American Kennel Club)
Open to Dogs Enrolled in the AKC Canine Partners Program.
.
Saturday, January 31st &
Sunday, February 1st, 2015
Classes offered (all levels, both days):
Standard, Jumpers with Weaves & T2B
Trial Site: Think Pawsitive LLC
2485 Commerce Dr
New Berlin, WI 53051
Each days entries Limited to 660 runs.
Method of Entry—Random Draw
Entries open: Wednesday, December 3, 2014 at 8:00am.
Any entries received before this date will be returned. No hand delivered entries accepted until 24
hrs after opening. Any envelope, mailed or hand delivered, containing more than the ten dog
maximum constitutes an invalid entry and will be returned.
All express mail must be left with no acceptance signature required.
Draw Period Closes: Friday, January 2, 2015 at 5:00pm
Draw Date: Friday, January 2, 2015 at 6:00pm
Draw Location: 1124 W River Dr, Stevens Point, WI 54481
Entries close Friday, January 16, 2015 at 6:30pm at the Trial
Secretary’s address, after which time entries cannot be accepted, canceled, altered, or
substituted except as provided for in Chapter 11, Section 6 of the Dog Show Rules.
Show Hours: Saturday and Sunday, 7:00am-7:00pm
AMERICAN KENNEL CLUB CERTIFICATION
Permission has been granted by the American Kennel Club for the
holding of this event under American Kennel Club Rules &
Regulations. James Crowley, Secretary.
Mail entries with fees (check or money order) payable to K-9 OTC to:
Lorah Marquardt, Event Secretary
Bluestem Agility Trial Services, LLC
1124 W. River Drive, Stevens Point, WI 54481
Questions? Call: (715) 342-0679 or Email (preferred): [email protected]
ENTRY FEES: $22.00 for the first entry of each dog per day (inc $3.50 AKC
recording fee); $16.00 for each additional entry of the same dog/the same day (inc $3.00
AKC recording fee).
VOLUNTEER WORKER SIGN-UP
K9 OTC Jan 31 & Feb 1, 2015
Please be generous with your time. Volunteers will receive lunch & a drink.
Name:
EMAIL:
Address:
(if no email)
WAIT LIST FOR WITHDRAWN ENTRIES:
A Wait List of a maximum of 25 entries will be maintained to fill openings created by entries
withdrawn after the closing date. All entries, including wait listed entries, must be received
prior to the closing date. Written notice to withdraw an entry must be received by the Trial
Secretary no later than 6pm on Monday, January 26, 2015. If a withdrawn entry is replaced
by a wait listed entry, a full refund will be issued for the withdrawn entry. Any wait listed entry
that does not move off the wait list into the trial, will receive a full refund.
K-9 OTC CLUB OFFICERS
President: Barb Adams
Treasurer: Monica Brammer
Phone:
I will sign up online. Link will be emailed to all entrants as soon as it is available.
(Form must be included with entry to be considered for a worker slot in the
random draw.)
Check classes entered and write in jump height divisions:
Vice President: Juli Cepulis
Secretary:
Shirley Wolcyk
11421 W Freistadt Rd
Mequon WI 53097
Saturday
Class
STD
Board: Chris Bach, Dick Bahr, Dr Kaye Krueger, Clif Sanders
Club Website: www.k9otc.com
JWW
EVENT COMMITTEE
Trial Chair: Barbara Szesterniak, [email protected], 262-227-3403
4515 Edington Lane, Brookfield, WI 53045
Members: Dave Bate, Sherry Kelber, John Schroepfer, Debbie Seder, Janis Shogren
Volunteer Coordinator: Debbie Seder, 262-246-4895, [email protected]
TRIAL JUDGES:
Terry Elger, 3439 N 79th St, Milwaukee WI 53222
Classes: Saturday: Standard; Sunday: Jumpers, T2B
Joan Mullen, W186 N7064 Marcy Rd, Menomonee Falls WI 53051
Classes: Saturday: Jumpers, T2B; Sunday: Standard
Height
Sunday
Class
Height
Exc/Mas
Open
Novice
Exc/Mas
Open
Novice
T2B
Check jobs you would be willing to work:
Job:
Sat
Sun
Job:
Course Builder
Gate Steward
Timer
Ring Crew
Scribe
Leash Runner
Transcribe
Scribe Sheet
Runner
Sat
Sun
Please note any additional information:
Thanks for volunteering—Your help is greatly appreciated! Contact volunteer coordinator
Debbie Seder, 262-246-4895, [email protected] with any questions.
RUNNING ORDER and START TIMES:
AKC AGILITY MOVE-UP FORM
MOVE-UP REGULATIONS:
If a dog earns an AKC agility title before this event, it can be advanced to the next
level of competition. Written notice must be given to the Trial Secretary no later
than 6pm on Monday, Jan 26, 2015. Day to day move-ups will be accepted if
received before the close of the trial Saturday, Jan 31, 2015. Trial close will be
considered to be the awarding of ribbons for the last class on that day. Move-ups will
be added to the end of the running order of the class they move up to and every effort
will be made to accommodate handlers running multiple dogs in the same class.
Move-up form must be submitted—Verbal requests will not be accepted. Fill out
each change and send to the Trial Secretary’s home address. E-mailed requests
accepted as long as all information is included.
-----------------------------------------------------------------------------------------------AKC Registered Name: _________________________________________
AKC Registration #: ___________________________________________
Breed: ____________________________ Call name: _________________
Owner(s): ____________________________________________________
4”
8”
12”
16”
20”
24”
STD
Move to:
Open
Exc
Mas
Move to:
Open P
Exc P
Mas P
Move to:
Open
Exc
Mas
Open P
Exc P
Mas P
STD Pref
JWW
JWW Pref
Move to:
Sunday
7:00 AM Check-in
7:45 AM General Briefing
7:00 AM Check-in
7:45 AM General Briefing
Ring 1
Ring 1
8:30 AM STANDARD:
8:30 AM STANDARD:
Excellent/Master 26, 24 / 20 / 16 / 12, 8, 4
Open -Tall to Small
Novice - Tall to Small
Excellent/Master 26, 24 / 20 / 16 / 12, 8, 4
Open - Tall to Small
Novice - Tall to Small
Ring 2
Ring 2
8:00 AM T2B Tall to Small
8:00 AM T2B Tall to Small
JUMPERS W/ WEAVES to follow
Excellent/Master 16 / 12, 8, 4 / 26, 24 / 20
Open - Tall to Small
Novice -Tall to Small
JUMPERS W/ WEAVES to follow
Excellent/Master 16 / 12, 8, 4 / 26, 24 / 20
Open - Tall to Small
Novice - Tall to Small
Please Note: Walk throughs to be split as shown, or where appropriate based on class size, to
insure adequate time for all. In case of conflict, the Standard ring will take precedence.
SITE INFORMATION:
All classes will be held indoors on artificial turf. Ring size is 73’ x 115’. Exhibitors and
spectators are expected to keep the entire area clean. Anyone witnessed not picking up after
their dogs on the trial grounds will be excused from the trial with no entry fees refunded.
Please respect neighboring businesses by not exercising dogs on their property. Building
will open at 6:30 am Saturday and Sunday.
VIEWING: For safety reasons, chairs are not allowed in the ring area. Sitting is not
allowed on the stairs near the rings, nor are dogs permitted to stand or wait on the stairs.
Day(s) Move-up requested for:
Height Division:
Saturday
CRATING:
Ample indoor crating space is available in multiple rooms on two levels. Much of the crating
space is on the 2nd floor. First floor crating space for those handlers physically unable to
climb stairs can be secured in advance. Please contact Trial Chair Barbara Szesterniak,
[email protected], 262-227-3403. Crates may be left overnight; however, K-9 OTC,
Think Pawsitive, LLC and Bluestem Agility Trial Services, LLC will not be responsible for
any lost or damaged items left at the show site. Dogs may not be left overnight.
PARKING: There is ample parking available in several lots. Watch for signs. No street or
overnight parking allowed.
CATALOGS: Running orders will be available online. Full catalogs will be available for
sale for $12.00 on the day of the trial, but supplies will be limited. Advanced catalog sales
$10.00. Please indicate on your entry form if you would like a catalog.
PRIZES AND AWARDS:
Rosettes will be awarded to Novice and Open and ribbons to Excellent for First through
Fourth place in each class and height division. Qualifying ribbons will be awarded to those
dogs receiving qualifying scores. New title ribbons, Double Q ribbons, PAX ribbons,
MACH & PACH ribbons and bars will also be awarded. Dogs must qualify to receive
placement ribbons. A dog toy will be offered for each dog entered in the trial. Prizes must
be claimed the day of the show -- none will be mailed.
JUMP HEIGHT DIVISIONS:
Owners are responsible for entering the proper height division.
Height at Withers
Jump Height Regular Classes
Jump Height Preferred Classes
11” and under
8 inches
4 inches
14” and under
12 inches
8 inches
18” and under
16 inches
12 inches
22” and under
20 inches
16 inches
Over 22”
24 inches
20 inches
26 inch jump height may be entered at the owner’s discretion.
HEIGHT CARD REQUIREMENT:
When filling out the entry form, please 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 list of dogs to be measured. If a measurement is necessary, it is solely the exhibitor’s
responsibility to have their dog measured prior to running. Exhibitors should have their dog’s original, official
jump height card or temporary jump height form available at each trial to present upon request. .Regulations
for Agility Trials, Chapter 2, Section 4.
REFUNDS:
No entry fees will be refunded if the trial cannot open or be completed by reason of riots, civil
disturbances, fire, act of God, public emergency, act of a public enemy, or any other cause beyond the
control of the organizing committee. Entry fees shall not be refunded in the event that a dog is absent,
disqualified, excused by a judge, or barred from competition by action of the Trial Committee. Entry fee
for bitches that come into season or a dog that is injured after the closing date will be refunded (less $12
administrative fee per day) if a veterinarian’s certificate is presented to the Trial Secretary 30 min prior to
the start of judging that day.
OBSTACLES:
Obstacles will meet the specifications in the current edition of the Regulations for Agility Trials.
Electronic timing, rubberized contacts and weave poles with 24” spacing will be used.
DOGS ELIGIBLE TO ENTER:
This trial is open to all dogs 15 months of age or older that are registered with the American Kennel Club,
or are registerable breeds that have obtained an AKC ILP or PAL number. Bitches in season, aggressive,
blind or deaf dogs or dogs suffering from any deformity, injury or illness which may affect the dog’s
physical or mental performance are ineligible to participate. Dogs that have been listed with AKC Canine
Partners may participate provided their listing number has been recorded on the entry form and the trialgiving club is offering the optional mixed breed classes
RINGSIDE:
Dogs not required at the trial until the scheduled time of judging. Dogs not needed for further judging are
excused. The owner or handler of each dog is solely responsible for having the dog ready at ringside
when the class is to be judged. Please help your fellow competitors, the trial workers, and the judge by
checking in with the gate steward well ahead of your turn, and being prompt at the line when your turn
comes to run. In case of conflicts, the Standard ring will take precedence all weekend.
SAFETY AND BEHAVIOR:
The safety of the dogs is our primary concern. By entering this trial, exhibitors acknowledge that they are
familiar with the rules and regulation of this sport and that their dogs are familiar with and able to perform
all obstacles safely. Exhibitors should follow their veterinarians’ recommendation to assure their dogs are
free of internal or external parasites, any communicable diseases, and have appropriate vaccinations.
LIABILITY:
It is expressly understood that exhibitors alone are responsible for the behavior of their dogs and/or
children. Any exhibitor whose dogs and/or children create unnecessary disturbances or repeatedly engage
in unsafe or disruptive behavior may, at the discretion of the Trial Committee, be asked to leave the show
site. In such cases, no refund of any fees paid will be made. K-9 Obedience Training Club, Bluestem
Agility Trial Services, LLC, Think Pawsitive, LLC, their members, agents, etc. will assume no
responsibility for any loss, damage or injury sustained by exhibitors or handlers, their dogs or property,
and further assumes no responsibility for injury to children.
FOOD:
Food and beverages will be provided for workers. Food for non-workers will not be available
for purchase. There are many restaurants within 5 minutes of the show site.
HOTEL INFORMATION:
The following area hotels accept well-behaved people and their pets. Exhibitors must contact
hotels directly and identify themselves as having dogs. Some of these hotels do charge an
extra fee for dogs. Be sure to verify the dog policy with the hotel of your choice when you
make your reservation. Please be a responsible owner and a considerate hotel guest by
maintaining a restful atmosphere and cleaning up after your dog.
La Quinta Inn & Suites
15300 West RockRidge Rd
New Berlin, WI
Phone: (262) 717-0900
La Quinta Inn & Suites
20391 West Bluemound Rd
Brookfield, WI
Phone: (262) 782-9100
Super 8
2510 Plaza Ct
Waukesha, WI
Phone: (262)786-6015
Extended Stay America
2520 Plaza Ct
Waukesha, WI
Phone: (262)798-0217
DIRECTIONS:
Think Pawsitive 2485 Commerce Dr. New Berlin, WI 53051
www.thinkpawsitivedog.com
GPS coordinates: N42° 59.972', W088° 07.180'
From the North:
Take US-41 S toward MILWAUKEE. Merge onto I-94 W via EXIT 38B toward MADISON.
Take the MOORLAND RD SOUTH exit, EXIT 301A.Merge to S. MOORLAND RD/CR-O
S. Turn RIGHT onto W LINCOLN AVE. Take the 2nd LEFT onto S COMMERCE DR. 2485
S COMMERCE DR is on the RIGHT.
From the South:
Take I-94 W/US-41N toward MILWAUKEE. Merge onto I-43 S via EXIT 316 on the LEFT
toward MADISON/FOND DU LAC. Take the CR-O/MOORLAND RD exit, EXIT 57. Merge
onto SMOORLAND RD/CR-O N toward BELOIT RD EAST. Turn LEFT onto W LINCOLN
AVE. Take the 2nd LEFT onto S COMMERCE DR. 2485 S COMMERCE DR is on the
RIGHT.
From the West:
Take I-94 E. Take the MOORLAND RD exit, EXIT 301A-B. Keep RIGHT at the fork to go
on S MOORLANDRD/CR-O S. Turn RIGHT onto W LINCOLN AVE. Take the 2nd LEFT
onto S COMMERCE DR.2485 S COMMERCE DR is on the RIGHT.
VETERINARIAN ON CALL:
Wisconsin Veterinary Referral Center
360 Bluemound Road
Waukesha, WI 53188
Tel: 866-542-3241
OFFICIAL AMERICAN KENNEL CLUB AGILITY ENTRY FORM
K-9 Obedience Training Club of Menomonee Falls
AGREEMENT
Jan 31 & Feb 1, 2015
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.
Opens:12/3/2014 ● Draw:1/2/2015 ● Closes:1/16//2015
SATURDAY
SUNDAY
BOTH DAYS
Standard
Jumpers
T2B
Daily Entry Fee: 1st run $22; $16 each additional run
Make checks payable to: K-9 OTC
Mail to: Lorah Marquardt, Event Secretary, 1124 W River Dr, Stevens Point WI 54481
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
T2B T2BP
Non-Regular Classes International Sweepstakes
ISC Jump Height - Select:
14”
18” 26” -or-
□ □ □
This Dog Needs To Be Measured
BREED
□Yes □No
□STD □JWW
□Jump Height Same as Regular/Preferred
SEX
HEIGHT AT WITHERS
VARIETY
CALL NAME
Enter Complete Registration # below
AKC® NO
PAL NO.
□
FOREIGN REG. NO & COUNTRY
BREEDER
DATE OF BIRTH
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
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.
___________________________________________________________________________________________________
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.
PLACE OF BIRTH (LIST COUNTRY)
□
SIRE
DAM
SIGNATURE of owner or his agent duly authorized to make this entry.
ACTUAL OWNERS
OWNERS ADDRESS
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.
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? _____________________________________________
AKC® NAME (INCLUDE AKC TITLES ONLY)
□
ILP NO. □
AKC Rules, Regulations, Policies and Guidelines are available on the American Kennel Club Web site, www.akc.org.
SIGN HERE
 NEW ADDRESS
X ______________________________________________________
Telephone Number:
CITY, STATE ZIP + 4
□New Email
Email Address:
HANDLER
ENTER JR. HANDLER # if applicable
Exhibitor or owner MUST sign on the signature line beneath the instructions.
In Case of Emergency - Name:
Phone #:
(NOT REQUIRED)
AEAGL2 (12/13)
OFFICIAL AMERICAN KENNEL CLUB AGILITY ENTRY FORM
K-9 Obedience Training Club of Menomonee Falls
AGREEMENT
Jan 31 & Feb 1, 2015
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.
Opens:12/3/2014 ● Draw:1/2/2015 ● Closes:1/16//2015
SATURDAY
SUNDAY
BOTH DAYS
Standard
Jumpers
T2B
Daily Entry Fee: 1st run $22; $16 each additional run
Make checks payable to: K-9 OTC
Mail to: Lorah Marquardt, Event Secretary, 1124 W River Dr, Stevens Point WI 54481
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
T2B T2BP
Non-Regular Classes International Sweepstakes
ISC Jump Height - Select:
14”
18” 26” -or-
□ □ □
This Dog Needs To Be Measured
BREED
□Yes □No
□STD □JWW
□Jump Height Same as Regular/Preferred
SEX
HEIGHT AT WITHERS
VARIETY
CALL NAME
PAL NO.
□
FOREIGN REG. NO & COUNTRY
BREEDER
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
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.
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? _____________________________________________
Enter Complete Registration # below
AKC® NO
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.
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.
AKC® NAME (INCLUDE AKC TITLES ONLY)
□
ILP NO. □
AKC Rules, Regulations, Policies and Guidelines are available on the American Kennel Club Web site, www.akc.org.
DATE OF BIRTH
___________________________________________________________________________________________________
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.
PLACE OF BIRTH (LIST COUNTRY)
□
SIRE
DAM
SIGNATURE of owner or his agent duly authorized to make this entry.
ACTUAL OWNERS
OWNERS ADDRESS
SIGN HERE
 NEW ADDRESS
X ______________________________________________________
Telephone Number:
CITY, STATE ZIP + 4
□New Email
Email Address:
HANDLER
ENTER JR. HANDLER # if applicable
In Case of Emergency - Name:
Exhibitor or owner MUST sign on the signature line beneath the instructions.
Phone #:
(NOT REQUIRED)
AEAGL2 (12/13)