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AKC Licensed

Agility Trials March 7-8, 2015

Events #2015260001& 2015260002

Premium List—AKC All-Breed Agility Trials

This event is accepting entries for dogs listed in the AKC Canine Partners Program

American Kennel Club Certification Permission is granted by the American Kennel Club for the holding of this event

under American Kennel Club rules and regulations.– James P. Crowley, Secretary

**offering ALL classes/levels**

Entries limited to 330 runs per judge (660 total) per day.

Entries accepted no sooner than 8am Tuesday, January 6, 2015.

RANDOM DRAW entries accepted until 4pm Wednesday, January 21.

Trial closes Tuesday, February 17, 4pm.

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Fieldhouse Family Sports & Wellness Center

300 Sunrise Center, Zanesville, OH 43701

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Judging begins

8am Saturday/Sunday

Trial Hours 6:30am-7pm

Trial held INDOORS on infilled

artificial turf; Fully enclosed rings,

80’ x 115’ (STD)

65’ x 130’ (JWW)

Time 2 Beat on

Sunday;

FAST on Saturday

Eastern Time Zone applies to all dates/times

GRCCO Club Officers

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The following hotels accept well-mannered dogs and handlers; some may charge additional fees for pets, so please call ahead to verify policies. Please clean up after your pets at the hotels! They are considered extensions of the show site, and we have requested they notify us of any problems so that appropriate actions may be taken. Additional info & show rates may be posted at www.furrydogs.com

• Best Western-Airport I-70 Exit 160, 4929 E Pike, Zanesville 740-453-6300

• Comfort Inn I-70 Exit 155, 500 Monroe St, Zanesville 740-454-4144

• Super 8 I-70 Exit 152, 2440 National Rd, Zanesville 740-455-3124

• America’s Best Value Inn I-70 Exit 160, 4925 E Pike, Zanesville 740-453-6002

• EconoLodge I-70 Exit 155, 135 N Seventh St, Zanesville 740-452-4511

• Baymont Inn I-70 Exit 155, 230 Scenic Crest Dr Zanesville 740-454-9332

• Motel 6 (former Ramada; not recommended) I-70 Exit 160, 4645 E Pike, Zanesville 740-453-0771

Hotel Information (ZIP code 43701)

Directions to the Trial and Show Site Information

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Trial Info/Updates at www.furrydogs.com/Agilitytrials.htm

Awards Titling Classes: A green ribbon will be awarded to all dogs receiving a qualifying score. Rosettes will be awarded to qualifying dogs placing 1st - 4th (plus a dog toy valued at up to $5) and to those complet-ing titles. Double Q & Triple Q ribbons are awarded for dogs earning a QQ or QQQ from Masters classes only. A large rosette, MACH bar, and MACH prize will be awarded to teams completing a MACH title. A large rosette & PACH/PAX bar will be awarded to any team completing a PACH/PAX title. All awards must be claimed at the trial; none will be mailed. Exhibitor Information Club or AKC event clothing may be worn by anyone. Clothing may display the person’s name, dog’s call name &/or the dog’s picture, but no titles. Writing or graphics must not be in poor taste or contain profanity. Clothing must not display any info that would be in conflict with a sponsor of the trial. Junior Handlers PLEASE be sure to indicate on the entry form whether a Junior handler will be running the dog, and include their JH number. It is now required to include this in the AKC catalogs, and addition after scoring of a trial has begun is difficult!

Judges & Judging Assignments Dale Mahoney Tom Slattery 18002 Dean Ln 4490 Neal Ave S Nampa, ID Afton, MN

Course Familiarization and Warm-Ups Handlers are permitted to walk the course, without a dog, prior to the start of the class. The walk-through is restricted to handlers entered in that class. Walk-throughs will be held prior to the Novice, Open, and Master/Excellent classes. Entry Fees each includes an AKC recording fee $22-first entry, each dog, each day ($3.50 AKC RF) $13-second entry, each dog, same day ($3 AKC RF) $11-third entry, each dog, same day ($3 AKC RF) **Junior Handler entry fees are reduced by $10/day**

President: Megan McClung, 6333 S Old 3C Hwy, Westerville, OH 43082 Vice-President: Dee Darst, 6247 York Rd SW, Pataskala, OH 43062 Secretary: Ruth Rusk, 1908 Lewis Center Rd, Lewis Center, OH 43035 Treasurer: Ruth Wylie, 7440 Home Rd, Delaware, OH 43015 Board of Directors: Nancy Burns, Donna Collier, Karen Elliott, Carol Lowy, Martha Noreault

Trial Chairperson Trial Secretary Event Committee

Dave Hirsch Rebecca Smith Dave Hirsch 2878 Etna St 8 Merrywood Lane Pauline Hosenfeld Columbus, OH 43209 Vienna, WV 26105-9488 Carol & Marc Lowy 614-235-5240 304-488-2871 Janice Schlegel udx2@aol.com Secretary@furrydogs.com Phyllis Sode Trial Coordinator: Glenn Rawsky (smawsky@furrydogs.com)

Ring Saturday Sunday Std 1 Slattery Mahoney

FAST Mas/Ex 1 Slattery n/a

JWW 2 Mahoney Slattery

FAST Op/Nov 2 Mahoney n/a

T2B 16” & 20” 1 n/a Mahoney

T2B all other 2 n/a Slattery

Food and indoor restrooms will be available at the show site. Overnight RV parking & camping at the show site is permitted (NO FEE); there is plenty of space. However, no services are available. Contact the Trial Coordinator (Rebecca Smith) if you have specific questions. No dogs may be left unsupervised overnight at the show site, but crates/ex-pens/shelters may be left at the owner’s risk. Please clean up after your dogs! This show is being held at a fitness center. No dogs are allowed in the restrooms! Directions: From the East, take I-70 to Exit 157; turn left (South) on SR-93 for 0.2mi; then turn right (West) onto US-22/US-40. Travel West for 1.1mi; Sunrise Center will be on your right (North). From the West, take I-70 to Exit 155 for OH-60S/OH-146E. Bear left onto Elberon Ave; go 0.1mi, and turn right (South) onto OH-60S/146E. Travel 0.2mi and turn left (East) onto US-22/US-40. Travel East for 1.2mi; Sunrise Center will be on your left (North).

Veterinarian On Call Saturday/Sunday: after-hours, and Sunday Brandywine Hospital for Pets same 1384 Brandywine Blvd call regular number (740-453-0539) and follow Zanesville, OH 43701 740-453-0539 instructions for doctor on call

Height Divisions

Dogs Eligible to Enter

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Trial Info/Updates at www.furrydogs.com/AgilityTrials.htm

Notice to Exhibitors Safety of the dog is our primary concern. By entering this trial, exhibitors acknowledge that they are familiar with the rules and regulations of this sport, and that their dogs are familiar with and able to perform all obstacles safely. Puppies under 4 months of age are prohibited from the show grounds.

All dogs must be on leash or confined except when being judged or when in the designated agility warm-up area.

***Faxed, telegraphed, telephoned, e-mailed, unsigned entries, or entries not on an official AKC Agility entry form (or photocopy) with signed Agreement and Instructions attached cannot be accepted.***

No entry shall be made and no entry shall be accepted which specifies any conditions as to its accep-tance. Express delivery entries must include a signature permitting them to be left at the Trial Secretary’s address without the recipient’s signature. If no recipient is present to sign receipt, entries may be returned to sender.

Entries will be acknowledged after entries close with identification numbers and a judging program. Should such acknowledgement not be received within a reasonable time, please contact the Trial Secretary. Confirmation of acceptance will be made if either an email address or a self-addressed, stamped postcard with checkboxes for each class entered is included with the entry.

Owners are responsible for errors made while filling out entry forms, whoever makes such errors. No entry fee will be refunded in the event of such errors or cancellation of entries after the published closing date. Please type or print carefully to minimize errors! Every effort will be made to find all duplicate entries; however, if an entry has been processed, no refund will be made.

Make all checks and money orders payable to POTC in US funds only. Please mail fees with en-tries. The Trial Secretary and GRCCO assume no responsibility for cash sent through the mail. Post-dated or returned checks do not constitute a valid entry fee. There will be a $20 service charge for returned checks.

Entry fees will not be refunded in the event that the dog is absent, disqualified, excused, or barred from competition by action of the event committee. No fees will be refunded if the trial cannot open or be completed in the event of riots, civil disturbances, fire, public emergency, act of a public enemy, or any other cause beyond the control of the trial committee. Entry fees less $5 per run will be refunded for injured dogs or bitches in season on the day of the trial if veterinary certification is presented no later than 30 minutes before the start of judging. Overpayment of less than $10 per dog per day will not be refunded except at the exhibitor’s request.

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 disrup-tive behavior may, at the discretion of the Event Committee, be asked to leave the trial site. In such case, no refund of any entry fees will be made.

Judges are not required to wait for any dog holding up a class. Handlers are respon-sible for the presence of their dogs in the judging ring when it is their turn to run. Dogs may arrive any time prior to their scheduled time of judging. Dogs not required for further judging will be excused.

Golden Retriever Club of Columbus OH., and its agents assume no responsibility for any loss, damage, or injury sustained by exhibitors, handlers, their dogs or property, or their children.

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Owners are responsible for entering the proper height division. All heights are as measured at the withers.

Regular Class(Preferred Class) jump height divisions: 8(4) inches ...... for dogs 11 inches and under 20(16) inches .. for dogs 22 inches and under 12(8) inches .... for dogs 14 inches and under 24(20) inches .. for dogs over 22 inches 16(12) inches .. for dogs 18 inches and under 26 inches ........ at owner’s discretion (n/a Preferred)

Dogs entered in Preferred classes must jump at a height 4” lower than the minimum height they would be required to jump in Regular classes as listed above.

Simplified Jump Height Card Process When filling out the entry form, there is a new section at the top of the form 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. It is solely the responsibility of the exhibitor to check the correct measurement box, enter your dog(s) in the correct jump height, have your dog(s) measured before running (if necessary), and to have your dog(s) height card(s) available to present, if requested.

This trial is open to all dogs 15 months of age or older that are registered with the American Kennel Club, or that have AKC Limited Registration, Purebred Alternative Listing/indefinite Listing Privileges (PAL/ILP), or an AKC Canine Partners listing number, or approved Foundation Stock Services (FSS) breeds are eligible to participate. 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.

AVMA Health Statement "Exhibitors should follow their veterinarians' recommendation to assure their dogs are free of internal and external parasites, any communicable diseases, and have appropriate vaccinations."

Class Information (see also Chapters 6-9 of the Regulations for Agility Trials) The following levels and divisions are offered for Standard, JWW, and FAST classes:

Regular Preferred Novice A & B Novice Open Open Master/Excellent Master/Excellent Dogs must be entered only in Preferred or in Regular classes, with no crossover between them being allowed at the same set of trials.

All obstacles will conform to requirements as specified in the current revision of the “Regulations for Agility Trials” from the American Kennel Club (available at www.akc.org).

** Rubberized contact surfaces will be used at the trial.**

Obstacles

Trial Info/Updates at www.furrydogs.com/AgilityTrials.htm

Agility Trial Move-Up Request Trial: Golden Retriever Club of Columbus OH Dates: [ ] Saturday, March 7, 1015 [ ] Sunday, March 8, 2015 Mail to: Rebecca Smith GRCCO Trial Secretary 8 Merrywood Lane 304-488-2871 Vienna, WV 26105-9488 Secretary@furrydogs.com

***Only mail or e-mail requests will be accepted*** From Chapter 1, Section 20: Dogs may be moved up to a higher class at the request of the owner, as a result of qualify-ing for an agility title, provided that the request is made in writing to the Trial Secretary not later than 6pm on the Monday preceding the trials. Such move-up requests shall be accepted subject to availability of the class (i.e. that it is offered in the Premium List and that the entry limit, if any, will not be exceeded) and the payment of any difference in entry fee. Entry move-up valid only if the dog was already entered at the event indicated above and only if approved by the Trial Secretary.

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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 agility trial, and by any additional rules and regulations appearing in the premium list for this agility trial, and further agree to be bound by the “agreement” printed on the reverse side of the original 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. ———————————————————————————————————–——– —————————– SIGNATURE of owner or agent duly authorized to make this entry Date

Dog’s Registered Name Call Name

AKC Registration Number Armband Number

Owner’s name:

Phone #: email:

4

Entries accepted no sooner than Tuesday, January 6 at 8am; finish date for entry into the random draw opening period is Wednesday, January 21 at 4pm. Random draw will be held on Thursday, Jan 22 at 7pm, at the Trial Secretary’s home (see pg2). Entries close 4pm Tuesday, February 17. If entry limits are not reached during the opening period, they will be filled on a “first received” basis until the closing date. Entries for a maximum of ten (10) dogs are allowed in each envelope submitted to the Trial Secretary for the random draw. Envelopes containing entries for more than 10 dogs shall be treated as an invalid entry and will be returned. In the event an envelope is drawn that contains entries that would exceed the entry limit, there will be a random draw of the individual entries contained therein to fill the specified entry limit. If the entry limit is reached during the draw, all remaining entries shall be drawn for a position on the waitlist. All Random Draw rules and regulations as they appear in Chapter 1, Section 16 of the Regulations for Agility Trials shall apply.

Random Draw

Move-Ups Dogs may be moved up to a higher class at the request of the owner. This request must be made to the Trial Secretary by 6pm on Monday, March 1, by mail or e-mail (see form on p.9). Day-to-day move-ups must be requested in writing at the trial site before the close of trial on the preceding day.

Confirmations, Corrections, Entry Changes, and E-mail Per AKC regulations, changes to entries may be made until the closing date. After that time, only moveups are permitted until the moveup deadline. Corrections to entries due to Secretarial error may be requested at any time; however, any day of show corrections cannot be guaranteed to be reported to AKC correctly!!. Preliminary confirmations will be emailed within 7 days of receipt of your entry if a valid email address is provided; PLEASE be sure to add Secretary@furrydogs.com to your address book/whitelist to ensure the email reaches you, so you can check your information promptly!

Call for Volunteer Workers We are a small club and we would greatly appreciate any help at the trial! • Per AKC regulations, (Chapter 1, Section 16) for Random Draw entries, we will guarantee entry

for dogs of “Show Workers” who work at the trial. We are allowed to guarantee entry to 65 handlers each day.

• Vouchers valid for lunch, vendors, or towards a future entry will be provided for workers. If you can help out, please include this form with your entry, or contact Sharon Rooks (304-375-6489 or sharar-shelties@suddenlink.net) ASAP if you have already submitted your entry. I will help: [ ] Saturday [ ] Sunday I am experienced or [ ] Gate Steward [ ] Bar Setter/Chute Fluffer [ ] Course Builder familiar with: [ ] Leash Runner [ ] Scribe sheet Runner [ ] Assistant Scribe [ ] Timer [ ] Scribe I’m entered in (levels & heights): Std____________ JWW_________FAST/T2B_________ Name:_____________________ Dog(s):________________________________ E-mail:__________________________________ Phone:______________

Division (circle one): Regular / Preferred Jump Height (circle one): 4 8 12 16 20 24 26 Class (circle one): STD JWW FAST From Level (circle one): NovA NovB NovP Open Excellent To Level (circle one): NovB Open Exc Master

Wait List for Withdrawn Entries after the Closing Date/Time GRCCO is offering a Wait List to fill openings created by withdrawn entries after the trial's closing date/time. A maximum of 20 runs per trial day will be placed on the club's wait list. All entries, includ-ing wait listed entries, must be received by the Trial Secretary prior to the normal closing date.

Any withdrawals that are received by 6pm Thursday, February 26th will be replaced by a wait listed entry if any are available. If a withdrawn entry is replaced by a wait listed entry, a full refund will be issued for the withdrawn entry. Withdrawals (except BIS is injury withdrawals) will not receive a refund if there are no waitlisted entries to backfill the withdrawn runs.

Any wait listed entry that does not move off the wait list into the trial by the above final withdrawal deadline will receive a full refund for waitlisted runs.

OFFICIAL AMERICAN KENNEL CLUB AGILITY ENTRY FORM

Golden Retriever Club of Columbus OH Opens: 8am Tues Jan 6th ● Draw Deadline: 4pm Weds Jan 21st ● Closes: 4pm Tues Feb 17th

Sat 3/7 Sun3/8 [ ] I must have both STD+JWW each day

STD: [ ] [ ] [ ] Worker Volunteer

JWW: [ ] [ ]

FAST: [ ] n/a

T2B: n/a [ ] [ ] Junior Handler Discount ($10/day)

Daily Entry Fees: 1st run $22; 2nd run $13; 3rd run $11; Make checks payable to POTC Mail to: Rebecca Smith, GRCCO Trial Secretary; 8 Merrywood Ln, Vienna, WV 26105-9488

Express entries must NOT require recipient signature, or they may be returned to sender!

ENTRY FEE ENCLOSED

IMPORTANT: Carefully read instructions before filling out!

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 8” 12” 16” 20” 24” 26”

STD NovA NovB Open Exc Master

JWW NovA NovB Open Exc Master

FAST NovA NovB Open Exc Master

T2B T2B

PREFERRED Classes 4” 8” 12” 16” 20”

STD NovP OpenP ExcP MasterP

JWW NovP OpenP ExcP MasterP

FAST NovP OpenP ExcP MasterP

T2B T2BP

Non-Regular Classes International Sweepstakes □STD □JWW ISC Jump Height - Select: □14” □18” □26” -or- □Jump Height Same as Regular/Preferred

This Dog Needs To Be Measured □Yes □No

SEX HEIGHT AT WITHERS

BREED VARIETY CALL NAME

AKC® NAME (INCLUDE AKC TITLES ONLY)

AKC® NO □ Enter Complete Registration # below

ILP NO. □ PAL NO. □

FOREIGN REG. NO & COUNTRY □

DATE OF BIRTH

PLACE OF BIRTH (LIST COUNTRY)

BREEDER

SIRE

DAM

ACTUAL OWNERS

OWNERS ADDRESS � NEW ADDRESS

CITY, STATE ZIP + 4

HANDLER ENTER JR. HANDLER # if applicable

Exhibitor or owner MUST sign on the signature line beneath the instructions.

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

AGREEMENT

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. 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 any additional rules and regulations appearing in the premium list of this event and entry form and any decision made in accord with them. I (we) agree that the club holding this event has the right to refuse this entry for cause which the club shall deem sufficient. I (we) certify and represent that the dog entered is not a hazard to persons or other dogs. 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 person. I (we) agree that the determination of whether the injury is serious shall be made by the event veterinarian and is binding on me (us). 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 THIS 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 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.

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? _____________________________________________

SIGNATURE of owner or his agent duly authorized to make this entry.

SIGN HERE X ______________________________________________________

Telephone Number:

Email Address: □New Email

In Case of Emergency - Name: Phone #:

AEAGL2 (12/13)

OFFICIAL AMERICAN KENNEL CLUB AGILITY ENTRY FORM

Golden Retriever Club of Columbus OH Opens: 8am Tues Jan 6th ● Draw Deadline: 4pm Weds Jan 21st ● Closes: 4pm Tues Feb 17th

Sat 3/7 Sun3/8 [ ] I must have both STD+JWW each day

STD: [ ] [ ] [ ] Worker Volunteer

JWW: [ ] [ ]

FAST: [ ] n/a

T2B: n/a [ ] [ ] Junior Handler Discount ($10/day)

Daily Entry Fees: 1st run $22; 2nd run $13; 3rd run $11; Make checks payable to POTC Mail to: Rebecca Smith, GRCCO Trial Secretary; 8 Merrywood Ln, Vienna, WV 26105-9488

Express entries must NOT require recipient signature, or they may be returned to sender!

ENTRY FEE ENCLOSED

IMPORTANT: Carefully read instructions before filling out!

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 8” 12” 16” 20” 24” 26”

STD NovA NovB Open Exc Master

JWW NovA NovB Open Exc Master

FAST NovA NovB Open Exc Master

T2B T2B

PREFERRED Classes 4” 8” 12” 16” 20”

STD NovP OpenP ExcP MasterP

JWW NovP OpenP ExcP MasterP

FAST NovP OpenP ExcP MasterP

T2B T2BP

Non-Regular Classes International Sweepstakes □STD □JWW ISC Jump Height - Select: □14” □18” □26” -or- □Jump Height Same as Regular/Preferred

This Dog Needs To Be Measured □Yes □No

SEX HEIGHT AT WITHERS

BREED VARIETY CALL NAME

AKC® NAME (INCLUDE AKC TITLES ONLY)

AKC® NO □ Enter Complete Registration # below

ILP NO. □ PAL NO. □

FOREIGN REG. NO & COUNTRY □

DATE OF BIRTH

PLACE OF BIRTH (LIST COUNTRY)

BREEDER

SIRE

DAM

ACTUAL OWNERS

OWNERS ADDRESS � NEW ADDRESS

CITY, STATE ZIP + 4

HANDLER ENTER JR. HANDLER # if applicable

Exhibitor or owner MUST sign on the signature line beneath the instructions.

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

AGREEMENT

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. 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 any additional rules and regulations appearing in the premium list of this event and entry form and any decision made in accord with them. I (we) agree that the club holding this event has the right to refuse this entry for cause which the club shall deem sufficient. I (we) certify and represent that the dog entered is not a hazard to persons or other dogs. 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 person. I (we) agree that the determination of whether the injury is serious shall be made by the event veterinarian and is binding on me (us). 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 THIS 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 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.

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? _____________________________________________

SIGNATURE of owner or his agent duly authorized to make this entry.

SIGN HERE X ______________________________________________________

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AEAGL2 (12/13)