Entry Form

Sat, February 23, 2013

Sun, February 24, 2013

Prepaid catalog  $5.00

Entry Fees: Please see page 4 of the Premium

Entries close: Wednesday Noon, February 6, 2013 at the show secretary's home 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.

BREED: Shetland Sheepdog   SEX:

DOG SHOW CLASS:   CLASS DIVISION:

ADDITIONAL CLASSES:

JR SHOWMANSHIP CLASS:

NAME OF JR HANDLER:   JR HANDLER NUMBER:

FULL NAME OF DOG:

AKC NUMBER:   DATE OF BIRTH:

PLACE OF BIRTH: USA    CANADA    FOREIGN

BREEDER:

SIRE:  DAM:

ACTUAL OWNER:

OWNER'S ADDRESS: 

CITY:   STATE:   ZIP:

NAME OF OWNER'S AGENT AT THIS SHOW:

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

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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 ant provider of services that are necessary to hold this event and ant 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 ant 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 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 in 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

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, INTERPRETATION AND

EFFECT OF THIS AGREEMENT SHALL BE SETTLED BY ARBITRATION PURSUANT TO THE APPLICABLE

AKC BYLAWS, RULES, REGULATIONS AND PROCEDURES MUST FIRST BE FOLLOWED AS SET FORTH IN THE

AKC CHARTER ABD BYLAWS, RULES, REGULATIONS, PUBLISHED POLICIES AND GUIDELINES.

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

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) 816-3776.

By checking the box 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 top of this form, what is the relationship

of the Junior Handler to the owner?

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" listed above. 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.

Checking this box is accepted as my signature.

TELEPHONE # E-MAIL ADDRESS:

After submitting your entries please come back to this page and make payment below