Akc Entry Form – Fill Out and Use This PDF

OFFICIAL ENTRY FORM

I ENCLOSE $ ________for entry fees

IMPORTANT-Read Carefully Instructions on Reverse Side Before Filling Out. Numbers in the boxes indicate sections of the instructions relevant to the information needed in that box (PLEASE PRINT)

BREED 5				VARIETY 1				SEX
DOG 2,3							CLASS 3
SHOW							DIVISION
CLASS							Weight, color, etc.
ADDITIONAL CLASSES			OBEDIENCE CLASS (Jump Height)			RALLY CLASS (Jump Height)				JR. SHOWMANSHIP CLASS

AKC Rules, Regulations, Policies and Guidelines are available on the American Kennel Club Web site, www.akc.org

AGREEMENT

I (we) agree that the club holding this event has the right to refuse this 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 the negligence of the aforementioned parties or any of their employees, 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 ATTEN- DANCE 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, 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 APPLICA- BLE AKC BYLAWS, RULES, REGULATIONS AND PROCEDURES MUST FIRST BE FOLLOWED AS SET FORTH

NAME OF (See Back)

JUNIOR HANDLER (If any)

FULL

NAME

OF DOG

Enter number here

AKC® NO.

PAL/ILP NO.

FOREIGN REG NO. & COUNTRY

BREEDER

JR. HANDLER

NUMBER

DATE OF

BIRTH

PLACE OF

BIRTH (list country)

Do not print the above in catalog.

IN THE AKC CHARTER AND BYLAWS, RULES, REGULATIONS, PUBLISHED POLICIES AND GUIDELINES.

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.The following categories of dogs may be entered and shown in Best of Breed competition: Dogs that are Champions

of Record and dogs which, according to their owners’records, have completed the requirements for a championship, but whose championships are unconfirmed. The showing of unconfirmed Champions in Best of Breed competition is limited

to a period of 90 days from the date of the show where the dog completed the requirements for a championship.

SIRE

DAM

4

ACTUAL OWNER(S)___________________________________________________________________________________

(Please Print)

OWNER’S ADDRESS___________________________________________________________________________________

CITY__________________________________________________STATE_____________________ ZIP________________

NAME OF OWNER’S AGENT

(IF ANY) AT THE SHOW _________________________________________________________________________

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 foregoing 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.

■SIGNATURE of owner or his/her agent

duly authorized to make this entry ________________________________________________________________________________

TELEPHONE #______________________________________________E-MAIL Address____________________________________

Are you a new exhibitor?

Yes

No

Owner/Handled Eligible?

Yes

No

E-MAIL Address (An acknowledgement or receipt of entry may be sent to this e-mail address):

Emergency contact:_____________________________________________Telephone_______________________________________

3.(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, age division, color division, weight division.

4.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.)

5.Mixed Breed dogs entering classes for Agility, Obedience, and Rally trials should mark Breed as “All-American Dog/Mixed Breed.” Sire and Dam information shall remain blank for mixed breed entrants.

If this entry is for Junior Showmanship, please give the following information:

JUNIOR SHOWMANSHIP

JR.’S DATE OF BIRTH

AKC JUNIOR HANDLER NUMBER

The above number MUST be included. Should you not have your Junior Handler number, this may be obtained from the American Kennel Club. Phone: (919) 233-9767.

By signing the entry form I (we) certify that the Junior Showman does not now, and will not at any time, act as an agent/handler for pay while continuing to compete in Junior Showmanship.

ADDRESS___________________________________________________________________________________________________

CITY_______________________________________________________ STATE____________________ ZIP__________________

■If 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?

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