The Welsh Springer Spaniel Club of America, Inc.

Combined Premium List: Friday - TD #2011167012,TDX #2011167011, VST #2011167013, Agility #2011167003 Saturday - Obedience #2011167014, Rally #2011167005 Monday -

Hunt Test #2011167015

These events are open to Welsh Springer Spaniels Only

In and Around Purina Farms, Gray Summit, MO

Tracking Test – Friday, September 16 Tracking Dog Excellent Test – Friday, September 16 Versatile Surface Tracking – Friday, September 16

Agility Trial – Friday, September 16 Obedience Trial – Saturday, September 17

Rally Trial – Saturday, September 17 Hunt Test – Monday, September 19

Conformation & Sweepstakes Classes held by the Three Rivers Kennel Club of Missouri on Saturday, September 17 and Sunday,

September 18 (Sweepstakes on Saturday only)

Events sponsored by Betsie Czeschin, Central States Welsh Springer Spaniel Club, Dogwood Welsh Springer Spaniel Club, Pacific Northwest Welsh Springer

Spaniel Club, and the Iron Welsh Challenge Committee

American Kennel Club Certification Permission has been granted by the American Kennel Club for the holding of these events under the American Kennel Club Rules and Regulations James P. Crowley, Secretary

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WSSCA Club Officers President: Cindy Ford 781 W. Fisher Rd, Cantrall, IL 62625 Vice-President: Sandy Holmes 19400 N. Territorial, Chelsea MI 48118 Treasurer: Mary Johnson 3868 River Walk Dr., Duluth, GA 20096 Secretary: Carla Vooris 284 Welshie Way Lane, Henderson, NC 27537

Iron Welsh Challenge Committee Andrea Pease, Betsie Czeschin, Donna Wesemann, Franna Pitt, Kim Laird, Lisa

Sinke, Peggy Ruble, Susan Willingham

Secretary – Tracking, Agility, Obedience, Rally, Hunt Test Betsie Czeschin

PO Box 1966, Mountain Home, AR 72654 402 Combs Ave., Cotter, AR 72626

870-435-1444 betsie@mtnhome.com

ENTER THE WSSCA EVENTS: ONLINE THROUGH Foy Trent Dog Shows: http://foytrentdogshows.com or by mail to the Secretary, Betsie Czeschin. Enter Conformation, Sweeps and Special Attraction through Onofrio Dog Shows, http://www.onofrio.com and Three Rivers Kennel Club.

Tracking, Tracking Dog Excellent, Variable Surface Tracking Tests

Chairman: Betsie Czeschin, PO Box 1966, Mountain Home, AR 72654

Committee: Kim Laird, Lisa Sinke, Donna Wesemann, Susan Willingham, Franna Pitt

Friday, September 16, 2011, Test Hours: 3 am – 4 pm Sullivan Industrial Park, Regional Airport and Vicinity, Sullivan, MO Entry Fee: TD - $50, TDX or VST - $90 Closing Date: September 6, 2011 at 6 pm (TD), 6: 30 pm (TDX), 7 pm (VST) at the Secretary’s home.

Judges: Ms. Jean Hilbig (22218) -------------- 12000 W 76th Ave, Arvada, CO 80005 Mr. Ule James (19384) ---------------- 4517 Sage Rd, Rochester, IL 62563 Dr. C. Danae Steele (42416 ) ------- 739 S Quincy St, Green Bay, WI 54301 (TD only) See additional details in this Premium List.

Agility Trial Chairman: Donna Wesemann, 364 Welshie Way Lane, Henderson, NC 27544

Committee: Betsie Czeschin, Susan Willingham, Lisa Sinke, Andrea Pease, Kim Laird

Friday, September 16, 2011, Trial Hours: 2 pm -10 pm Purina Farms, 200 Checkerboard Drive, Gray Summit, MO 63039 Entry Fee: $15 per class - Standard, JWW, FAST and Time to Beat Closing Date: August 31, 2011, 6 pm, at the Secretary’s home 90’ x 110’ ring, Outdoors on Grass. Option to move indoors on padded floor.

Judge: Dr. Franna Pitt (2941) ---------- 3880 53rd St. SE, Auburn, WA 98092 See additional details in this Premium List.

Obedience Trial Chairman: Lisa Sinke, 9738 Gorsline Road, Battle Creek, MI 49014

Committee: Betsie Czeschin, Susan Willingham, Donna Wesemann, Andrea Pease, Kim Laird

Saturday, September 17, 2011 – starting at least 30 minutes after completion of TRKC’s Best in Show, Trial Hours: 2 pm – 10 pm Purina Event Center, 200 Checkerboard Drive, Gray Summit, MO 63039 Entry Fee: $20 per class – Novice A & B, Open A & B, Utility A & B, Beginner Novice, Graduate Novice, Graduate Open, Versatility, Veterans Closing Date: August 31, 2011, 6 pm, at the Secretary’s home

Judge: Patricia Nevins (7613) ------ 5155 Balmoral Ln, Bloomington, MN 55437 See additional details in this Premium List.

Rally Trial Chairman: Lisa Sinke, 9738 Gorsline Road, Battle Creek, MI 49014

Committee: Betsie Czeschin, Susan Willingham, Donna Wesemann, Andrea Pease, Kim Laird

Saturday, September 17, 2011 – starting at least 30 minutes after completion of TRKC’s Best in Show, Trial Hours: 2 pm – 10 pm Purina Farms, Gray Summit, MO Entry Fee: $20 per class – Novice A & B, Advanced A & B, Excellent A & B, Novice Team Closing Date: August 31, 2011, 6 pm, at the Secretary’s home Judge: Patricia Nevins (7613) ------ 5155 Balmoral Ln, Bloomington, MN 55437 See additional details in this Premium List.

Hunt Test Chairman: Christine Wheeler, 12417 Augusta Drive Kansas City, Kansas 66109

Committee: Peggy Ruble, Dee Feltus, Mark Wheeler, Franna Pitt, Sandy Holmes

Monday, September 19, 2011, Test Hours: 7 am to 8 pm Approximate start time – 9 am Big River Hunting Club and Preserve, 11444 State Hwy. WW, Fletcher, MO Entry Fee: $65 per dog – Junior, Senior, Master Closing Date: September 6, 2011 at 8:00 pm at the Secretary’s home. Chukar will be used in all Levels. Other game birds and/or pigeons will be used at the test committee’s discretion. Judges: Dr. C. Danae Steele (42416 ) ------- 739 S Quincy St, Green Bay, WI 54301 Paul Morrison (ZF646) ------------------ 11450 Durand Rd, Howell, MI 48855 See additional details in this Premium List.

Approximate Event Locations – see detailed directions in descriptions

Eat, Drink, and Be Merry!

Thursday – Help lay tracks and enjoy snacks and beverages with the

crew. Contact Betsie Czeschin for details. betsie@mtnhome.com

Friday am – Join us at the Tracking Tests for Continental Breakfast

and cheering on the teams. Sullivan Skating Ring Annex, Sullivan, MO

Friday afternoon – Tracking Celebration Al Fresco Brunch at Purina

Farms Agility Ring, followed by the Agility Trial

Friday Evening – Welcome Reception at Purina Farms Agility Ring.

Help with the trial and watch the fur and ears fly!

Saturday Evening – Socializing at the Obedience and Rally Trials at

Purina Farms Event Center. Don’t miss the ever popular Rally Team

Class – Root for your favorite Welshie Team! Enter the class for

added fun! Form your own team or send your name to Betsie and

you’ll be assigned to a team.

Saturday Night – Post Trial Baby Shower welcoming a third

generation of Welsh Springer Spaniel Fanciers!

Sunday Afternoon, following Best of Breed – Update on the Iron

Welsh Challenge with ONE event to go. Awards and Accolades to

Iron Welsh Qualifiers to this point.

Sunday Evening – Barbeque and Dock Dog Diving Practice at Purina

Farms Visitor Center

Monday – Tasty Sandwich lunches available on the Hunt Test grounds

- $7 each. Iron Welsh Awards Celebration after the Hunt Test

All Events: Closing Date: Entries will be accepted until stated closing date and time, after which time entries will not be accepted, canceled, altered or substituted. All entries must be delivered to Betsie Czeschin – Chair, PO Box 1966, Mountain Home, AR 72654 or entered online through Foy Trent Dog Shows. Overnight and express mail entries MUST specify NO SIGNATURE REQUIRED.

MOVE-UPS: Move-ups after entries close must be submitted to the Trial Secretary in writing by 6:00 PM CDT on Monday, September 12, 2011. Include dog’s call name, registration number, owner’s name, class and event you are moving from, and class you are moving to. Send via mail, or email to betsie@mtnhome.com. No phone move ups accepted.

AKC Fees: Current AKC fees for each event are included in the entry fees and will be forwarded to the AKC per AKC Rules and Regulations. Exhibitors should follow their veterinarian’s recommendation to insure their dogs are free of internal and external parasites and communicable diseases and have appropriate vaccinations.

Refunds: A refund of the full entry amount will be given for any bitch that comes into season, provided that written notification is received by the Trial Secretary prior to the

start of the first class of that event, except in the tracking tests where bitches in season are allowed to compete and will run last. AKC Rules: All entrants are responsible for complying with the AKC Rules regarding each of these events.

The Conformation portion of the Iron Welsh Challenge is being held by the Three Rivers Kennel Club of Missouri. TRKC’s Premium List is

available from Onofrio Dog Shows. http://www.onofrio.com

Saturday, September 17 – WSSCA Supported Entry and Sweepstakes sponsored by Dogwood Welsh Springer Spaniel Club of Greater Atlanta (Conformation) and Statesman Welsh Springer Spaniels (Sweepstakes)

Judge: Dr. Bob G. Smith

Sweepstakes Classes : Puppy and Veterans

Special Attraction Classes: Iron Welsh Contenders with and without titles.

Sweepstakes and Special Attraction Judge: Julie Virosteck (17307)

Sunday, September 18 – WSSCA Supported Entry sponsored by Central States Welsh Springer Spaniel Club

Judge: Col. Jerry H. Weiss, USMC (Ret.)

TRKC Premium List available from Superintendent, Onofrio Dog Shows.

IMPORTANT INFORMATION FOR EXHIBITORS All dogs must be on leash at all times except when in the ring, when in the designated agility warm-up area or under judgment in the field. Exhibitors are responsible for being at the ring gate when it is their turn to run. Entry Confirmations and approximate check-in times will be sent to the email address on the Official AKC entry form after closing date. Hard copies will only be sent on request. If an exhibitor has not received a copy of the Schedule within seven days of the show, contact the Trial Secretary. Acknowledgment of receipt of entries prior to closing will be provided if the exhibitor provides a stamped, self-addressed postcard with entry. Conditional, unsigned, incomplete, illegible, telephone or telegraph entries cannot be accepted. Entries not on official AKC form, or photocopies of AKC forms, without the agreement attached are not acceptable. Entry fees will not be refunded in the event of errors or cancellation of entries after the published closing date, or in the event a dog is absent, disqualified, sick, lame, excused by the Veterinarian or Judge, or barred from competition by the Show Committee. No entry fee 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 public enemy, or any other cause beyond the control of the organizing committee. Confirmation of entry and schedule of judging time will be sent to the email address on the official AKC entry form after the closing date. If an exhibitor has not received a copy of the schedule at least seven days prior to the show, contact the Trial Secretary. Returned checks do not constitute a valid entry. Envelopes/transactions containing entries for more than the ten (10) dog maximum in the agility trial shall be treated as an invalid entry. The Welsh Springer Spaniel Club of America, Inc. and Purina Farms assume No responsibility for any loss, damage or injury sustained by exhibitors, handlers, or spectators, or to any of their dogs or property, and further assumes no responsibility for injury to any child not under the control of his or her parents or guardians. 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 disturbance or repeatedly engage in unsafe or disruptive behavior may, at the discretion of the Trial Committee be asked to leave the Trial site. In such case, no refund or any fees paid will be made. The safety of dogs is of primary concern. By entering any of these events, exhibitors acknowledge that they are familiar with the rules and regulations of the sport, and that their dogs are familiar with and able to perform all obstacles safely. Please clean up after your dogs on the show grounds and at your motel site. We want to retain these facilities for future events. ONLY DOGS THAT ARE ELIGIBLE to be shown under The AKC rules shall be allowed within the show precincts. OWNERS ARE RESPONSIBLE for errors in entry forms, regardless of who may make such errors.

This club does not agree to arbitrate claims as set forth on the Official AKC entry form for this event.

Ribbon and Rosette Prizes will be as follows:

Prize Regular

Classes

Non-Regular Classes

First Blue Rose

Second Red Brown

Third Yellow Light Green

Fourth White Gray

Qualifying Score – Dark Green Qualifying Score (Hunt Test) – Blaze Orange Highest Scoring Dog in the Regular Obedience Classes – Blue & Gold Highest Combined Score in Open B & Utility Obedience Classes – Blue & Green Highest Combined Score in Advanced B and Excellent Rally Classes – Blue & Silver Highest Scoring Dog in the Agility Classes – Blue & Gold

Awards for all Events: Qualifying Scores required for all Awards. All awards must be claimed at the event. Unless otherwise specified, awards are donated by the event sponsors. WSSCA reserves the right to substitute awards of equal or greater value.

Qualifying Scores (Agility, Obedience, & Rally): WSSCA “Q” Button and Dark Green Ribbon Dog Toy donated by Betsie Czeschin

Completing a Title (All Events): Dogs completing a title during these events will be awarded a 3 Streamer Rosette.

Tracking Tests: Dark Green Rosette, Framed, Personalized Certificate and WSSCA “Q” Button will be awarded to all Qualifiers.

Agility Trial: Ribbons will be awarded for First through Fourth place in each height division in each class. First Place in each class: WSS Calendar donated by the Greater Chesapeake Welsh Springer Spaniel Club. Second through Fourth in each class: Fleece Tug High in Trial: 3 Streamer Rosette and WSS theme bag. High in Trial will be determined first by the highest number of qualifying scores, and if tied, by the highest cumulative score – score from Standard, JWW, and FAST, plus points earned in T2B. At least one qualifying score is required. All dogs receiving their MACH or PACH at this trial will receive a jump bar and Rosette. Please notify the trial secretary if you are close to either title.

Obedience Trial: Ribbons will be awarded for First through Fourth place in each class. First Place in each class: WSS Calendar donated by the Greater Chesapeake Welsh Springer Spaniel Club. Second through Fourth in each class: Fleece Tug High in Trial: 3 Streamer Rosette and WSS theme bag. Highest Combined Score from Open B and Utility: 3 Streamer Rosette and WSS theme bag.

Rally Trial: Ribbons will be awarded for First through Fourth place in each class. First Place in each class: WSS Calendar donated by the Greater Chesapeake Welsh Springer Spaniel Club. Second through Fourth in each class: Fleece Tug Highest Combined Score from Advanced B and Excellent: 3 Streamer Rosette and WSS theme bag.

Hunt Test: Blaze Orange 3 Streamer Rosette, bird band, and WSSCA “Q” Button will be awarded for each Qualifying Score in all levels.

RV Parking The Three Rivers Kennel Club WILL BE IN CHARGE OF ALL PARKING FOR THIS EVENT. All RV parking reservations must go through their coordinator (see the TRKC Premium for details.). The fee for parking is $25.00 per night. Parking Exhibitor and visitor parking will be located on blacktop parking lots in front of Purina Event Center. Vehicles are limited to one parking space. No ex-pens, crates or cones allowed on blacktop; ex-pens and crates are allowed on grass areas. No parking in roadways or next to building. Grooming Grooming space must be reserved through the Three Rivers Kennel Club. Information is available in their Premium List. Hotels Crate dogs when left in motel rooms and pick up the grounds! The list below does not include all motels. However, those listed are within 15 miles of Purina. Travelodge Diamond Inn ...Interstate 44 & Hwy 100, Gray Summit, MO 63039 (636) 742-3501 1-800-782-8487 Econo Lodge…………….1725 W. 5th St.,Eureka, MO 63025 (636) 938-5348 1-800-251-1962 Eureka Super 8 ………… 1733 W. 5th St., Eureka, MO 63025 (636) 938-4368 1-800-800-8000 Super 8 Union…………….1015 E. Main St., Union, MO (636) 583-8808 Super 8 Washington…......2081 Eckelkamp Ct., Washington, MO 63090 (636) 390-0088 American Inn ....................1715 E. 5th St., Washington, MO 63090 (636) 239-3172 ROUTES TO PURINA FARMS EVENT CENTER I-44 FROM EAST OR WEST - Take Gray Summit exit (Hwy 100E). Turn north on Hwy 100E. Go approximately 1/2 mile. Turn left on MM. There are small Purina signs on the corner. MM is a winding road - large vehicles take care. Entrance to the Farm is about 1 mile on the left. There are large security gates.

SWAG!!!

Get your official Gateway Iron Welsh Challenge items from Café Press:

http://www.cafepress.com/GatewayIronWelshChallenge

GATEWAY IRON WELSH CHALLENGE Showcasing the Versatility of the Welsh Springer Spaniel

Gateway Iron Welsh Challenge Awards

Contenders – Any Welsh Springer Spaniel entered in at least three of the six Iron Welsh Events (show, rally, obedience, agility, field, tracking) – Iron Welsh Contender Button Qualifiers – Any Contender earning qualifying scores in at least 2 of the Iron Welsh Events – Custom Designed Qualifying Poster Bronze Award – Contender with the Third Highest number of Iron Welsh Points – Custom Designed Poster and Bronze Rosette Silver Award – Contender with the Second Highest number of Iron Welsh Points – Custom Designed Poster and Silver Rosette Champion/Gold Award – Contender with the Highest number of Iron Welsh Points – Custom Designed Poster, Gold Rosette, and Custom Award

Iron Welsh Challenge Details – Scoring Qualifying Scores from the 7 WSSCA events plus the two Supported Entries at TRKC, Sweepstakes and IWC Special Attraction classes count toward your Iron Welsh Challenge Point Total. Iron Welsh Contenders must compete in at least 3 of the 6 event types.

Event Conformation, Sweeps, SA Rally Obedience Agility Field Tracking

Points Award Class Class Class Level Test

1 2nd, 3rd, or 4th Novice

1 Nov Team

2 First Place Beg Nov

3 RWD/RWB Adv

4 BISw Exc Novice Nov JWW

4 BOSw Veterans Nov FAST

5 WD/WB Grad. Nov Nov Std TD

5 JH

6 Select Open Open JWW

6 AOM Open FAST

6 T2B

7 BB Grad.Open Open Std SH

7 BOS

8 Versatility Exc JWW TDX

8 Exc FAST

9 Exc Std

10 Utility MH VST

1 Participation Point for each event

3 PP's to any TD/TDX/VST alternate who doesn't get to run because of limits

Add Bonus Points - 3 for 3 IQ's, 6 for 4 IQ's, 9 for 5 IQ's, 12 for 6 IQ’s

First Tie Breaker - # of Events with Q's

Second Tie Breaker - # of Events entered

Third Tie Breaker - Total # of Q's in the Iron Welsh events. One qualifying score per event is tallied for your Iron Welsh Challenge total. Iron Welsh Qualifiers: Teams must earn qualifying scores in at least 2 events. Your Iron Welsh Point total is the sum of participation points, points from qualifying scores, and any bonus points.

GATEWAY IRON WELSH CHALLENGE Showcasing the Versatility of the Welsh Springer Spaniel

Each WSS must participate in at least Three of the Six Event Types

Sign Up Form – Please Include a Photo for the IWC Poster Dog’s Name with Titles

Call Name

Owner

Address

Breeder

Handler(s)

Entered in: Event (circle) Level/Class(es)

Tracking 9/16 TD, TDX, VST

Agility 9/16 Standard

JWW

FAST

Time 2 Beat

Obedience 9/17 Beginner Nov

Veterans

Graduate Novice

Novice, Open, Utility

Graduate Open

Utility, Versatility

Rally 9/17 Novice, Advanced, Excellent

Team, Novice

Sweepstakes 9/17 Puppy

Veteran

Special Attraction 9/17 Iron Welsh Challenge

Conformation 9/17 & 18 Regular Class

Regular Class

Non-Regular Class

Field 9/19 Hunt Test (Junior, Senior, Master)

Send form to:

Betsie Czeschin, P.O. Box is 1966, Mtn Home, AR 72654 For more information see http://www.wssca.com or contact Betsie at

betsie@mtnhome.com or Franna at frannap@everranch.com.

TD, TDX and VST Details:

Tracking HQ: Sullivan Skating Rink Annex, 301B Thurmond Memorial Drive, Sullivan, MO. Directions from Purina Farms – Enter I-44W toward St. Clair. Take Exit 225 toward MO-185, turn LEFT. Turn LEFT onto W. Springfield Rd/W. Springfield Ave. Turn SHARP RIGHT onto N. Park St. Turn RIGHT onto Bill Thurmond Memorial Drive.

Certification: Each entry for a dog that has not previously passed an AKC Tracking Dog

Test must be accompanied by a written statement, dated within one year of the date of the test, signed by a person approved by AKC to judge tracking tests, and must certify that the dog has satisfactorily performed a certification test.

Tracking Test Entries: Entry priority is to dogs not holding title in the test they’re

entering. In the event that the all of the tests are not filled by non-titled Welsh Springer Spaniels, titled Welsh Springer Spaniels will be allowed to run in the test.

Limits: The TD test is limited to 8 Welsh Springer Spaniels, the TDX test to 2 Welsh Springer

Spaniels, the VST test to 2 Welsh Springer Spaniels.

Exchange of Tracks: Tracks may be substituted from one test to another as follows: 2 TD

= 1 VST = 1 TDX

Each dog may only run in one of these three tests.

The Draw: A random drawing of all entries received by the closing date and time to

determine which entries will participate in the test will take place on Wednesday, September 6, 2011 at 6:00 PM (VST), 6:30 PM (TDX) and 7:00 PM (TD) at the home of the Test Secretary, PO Box 1966, Mountain Home, AR 72654. Contact the Secretary for directions if you wish to attend this drawing.

Alternate List: An alternate list will be maintained and will consist of entries received by the

closing date but not pulled in the initial draw. Drawing for the alternate list will immediately follow the drawing for entries which are to run.

Notification: Notification of the draw results will be made as soon as possible after entries

have closed. Should such notification not be received by the exhibitor within a reasonable time, please contact the Test Secretary.

Refund Policy: The entry fee shall be refunded if either 1) the entrant withdraws and

notifies the secretary prior to the drawing for tracks and an alternate runs the track or 2) the dog is an alternate who does not run the track.

Bitches in season may participate in accordance with AKC Tracking Regulations,

Chapter 2, Section 8. Please keep bitches in season in your vehicle and notify the Test Secretary upon arrival.

Draw for running order: All entrants must be at the test headquarters by the time

listed in the Judging Program on Friday, September 16, 2011, at which time there will be a draw for running order. Entrants not present at the time of their drawing will be marked absent and an alternate will be allowed to run in their place.

Judging will begin as soon as tracks have sufficiently aged. The tracking tests’ hours are

3 AM to 4 PM.

Dogs on leash: All dogs and bitches entered in this test must be kept on leash at all times.

Failure to comply may result in the dogs and handlers being excused from the test site and any awards earned may be withheld. This also applies to any non-entered dogs that may accompany anyone to the test.

Extreme weather conditions: The AKC believes that the welfare of dogs and

participants is of paramount importance. In the case of adverse weather conditions, the test could be canceled or rescheduled.

Post Test Brunch: All participants are invited to partake at a celebration brunch held at

the Purina Farms outdoor Agility Ring following the completion of the tracking tests.

Thank you to Dave Cochran and the Sullivan, MO Parks

and Recreation department for arranging the grounds for

these tracking tests!

Agility Trial Details: OBSTACLES: Obstacles shall meet the specifications for obstacles in the current edition of AKC Regulations for Agility Trials. There will be No Novice Contact Equipment Familiarization.

DOGS ELIGIBLE TO ENTER This Trial is open to all Welsh Springer Spaniels over the age of 15 months that are registered with the American Kennel Club or that have obtained ILP/PAL numbers from AKC, except bitches in season, aggressive dogs, blind or deaf dogs, or dogs suffering from any deformity, injury or illness which may affect the dog’s physical or mental performance.

HEIGHT DIVISION The following lists the required jump height for Preferred, and minimum height for regular agility classes. Judge’s only reserve the right to measure dogs at the trial that do not possess an official height card.

Regular Preferred

8 inches for dogs 11 inches and under at the withers 4” Preferred class 12 inches for dogs 14 inches and under at the withers 8” Preferred class 16 inches for dogs 18 inches and under at the withers 12” Preferred class 20 inches for dogs 22 inches and under at the withers 16” Preferred class 24 inches for dogs over 22 inches at the withers 20” Preferred class 26 inches Dogs may be entered at this height at their owner’s discretion

CLASSES OFFERED: All levels of Standard, JWW, FAST, and Time to Beat agility, including the Preferred Classes will be offered. A complete set of rules for all classes is available from the American Kennel Club, 5580 Centerview Drive, Suite 200, Raleigh, NC 27606, or from the AKC web site. It is the exhibitor’s responsibility to enter their dog in the correct class. The Trial Secretary cannot make any changes (except for move-ups as noted) after the closing date of the trial. Be sure to check your entry form carefully and make certain you have entered the correct class(s).

PREFERRED CLASS INFORMATION: You may not enter the same dog in preferred and regular classes in the same set of shows (weekend).

JUMP HEIGHT INFORMATION: All dogs without height cards will have to be measured by the judge of record, except 24”/26” dogs. If a VMO or an AKC Representative is available, all dogs without height cards, including 24”/26” dogs, will need to be measured. 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 dogs 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. For complete details on the Jump Height Card Process go to www.k-9sports.com and click on the link on the Events page.

Obedience/Rally Details: Obedience and Rally will be held indoors at the Purina Farms Event Center. Obedience and Rally will start as soon as possible after the Three Rivers Kennel Club of Missouri’s show is completed, but no earlier than 30 minutes following Best in Show. Obedience will be followed by Rally. Depending on the entry, both the Obedience and Rally rings may run simultaneously, using an additional judge as needed.

Hunt Test Details:

The Hunt Test will be held at the Big River Hunting Club and Preserve in Fletcher, MO, starting no earlier than 9 am on Monday, September 19. Junior land work will be followed by Senior land work, then Master land work. Water work will follow land work. This order may be changed if necessary. Entries close at 8:00 P.M. CDT on Friday, September 7, 2011 Drawing for the running order will take place at 8:30 p.m. at the Secretary’s home. Everyone MUST wear Hunter Orange on the hunt test grounds. A limited number of orange vests and/or hats will be available to borrow. Chukar will be used in all stakes. Other game birds and/or pigeons will be used at the test committee’s discretion. Bitches in season are not allowed on the grounds of the hunt test.

Directions from Purina Farms: Enter I-44W toward St. Clair. Exit onto MO-47. Follow MO-47 south about 20 miles. Turn left onto State Highway H toward Fletcher. Turn left onto Mill Stone Drive at about 3 miles. Turn Right onto Still Creek Pass. The Big River Hunting Club is across County Highway WW.

OFFICIAL AMERICAN KENNEL CLUB ENTRY FORM

Welsh Springer Spaniel Club of America VST #2011167013, TDX #2011167011, TD #2011167012 September 16, 2011

Sullivan Industrial Park, Regional Airport and Vicinity, Sulivan, MO Entry Fee: $90.00 (VST or TDX), $50.00 (TD) (includes AKC recording fees) ENTRIES CLOSE: 6 PM (VST), 6:30 PM (TDX), 7:00 PM (TD), CDT, Wed, September 7, 2011 Checks payable to WSSCA, and mail to: Betsie Czeschin, POB 1966, Mtn. Home, AR 72654

Conditional, Unsigned or Incomplete entries or entries received without fees will not be accepted. Telephone or FAX entries are not acceptable. All cancellations must be written and received by the Show Secretary before closing date. Also required: Original TD certification (no photocopies) must accompany the entry for any dog that has not earned a tracking title.

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 Welsh Springer Spaniel VARIETY 1 SEX

DOG 2, 3

SHOW CLASS

CLASS 3 DIVISION Weight, color, etc

ADDITIONAL CLASSES

OBEDIENCE CLASS RALLY CLASS (Jump Height)

JR. SHOWMANSHIP CLASS

NAME OF (See Back)

JUNIOR HANDLER (if any)

JR. HANDLER NUMBER

FULL NAME OF DOG

Enter Number Here

□ AKO REG NO.

□ AKC LITTER NO.

□ ILP NO.

□ FOREIGN REG NO & COUNTRY

DATE OF BIRTH

PLACE OF □ USA □ Canada □ Foreign

BIRTH

BREEDER

SIRE

DAM

ACTUAL OWNER (S) 4 (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 agent

duly authorized to make this entry

TELEPHONE #

E-MAIL Address (An acknowledgment or receipt of entry may he sent to this e-mail address)

AKC Rules, Regulations, Policies anda 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 to have been cause 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 forementioned 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 RO 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 EFFET 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

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. 3. (Dog Show Class) Consult the classification in this premium list. If the dog show 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 a show 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 name. State on entry form whether transfer application has been mailed to the AKC. (For complete rules, refer to Chapter 11, Section 3.)

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) 816-3776. 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? _________________________________________________________________________

AEAGL2 - (07/09)

OFFICIAL ENTRY FORM FOR AGILITY TRIALS

(IMPORTANT: CAREFULLY READ INSTRUCTIONS ON REVERSE SIDE BEFORE FILLING OUT) HEIGHT AT

BREED WELSH SPRINGER SPANIEL SEX [ ] MY DOG NEEDS TO BE MEASURED WITHERS

[ ] MY DOG HAS A TEMPORARY JUMP HEIGHT FORM

[ ] MY DOG HAS A PERMANENT JUMP HEIGHT CARD

REGULAR STANDARD AGILITY REGULAR JUMPERS WITH WEAVES REGULAR FAST (circle one) (circle one) (circle one)

NOV-A NOV-B OPEN EXC-A EXC-B NOV-A NOV-B OPEN EXC-A EXC-B NOV-A NOV-B OPEN EXC-A EXC-B

JUMP HEIGHT (circle one) 8 12 16 20 24 26

PREFERRED STANDARD AGILITY PREFERRED JWW PREFERRED FAST (circle one) (circle one) (circle one)

NOVICE-P OPEN-P EXC-AP EXC-BP NOVICE-P OPEN-P EXC-AP EXC-BP NOV-P OPEN-P EXC-AP EXC-BP

JUMP HEIGHT (circle one) 4 8 12 16 20

NON-REGULAR AGILITY CLASSES (if offered): INTERNATIONAL SWEEPSTAKES CLASS JUMP HEIGHT (circle one) (circle class) STD JWW 14 18 26

AKC® NAME (Include AKC titles only) CALL NAME OF DOG

(Enter number below) DATE OF BIRTH

[ ] AKC® NO. [ ] ILP [ ] PAL PLACE OF BIRTH (LIST COUNTRY)

[ ] FOREIGN REG. NO.

BREEDER

SIRE

DAM

ACTUAL OWNERS

OWNERS ADDRESS NEW ADDRESS

CITY, STATE, ZIP + 4

HANDLER IF JUNIOR HANDLER, PLEASE ENTER # BELOW FEE ENCLOSED

EXHIBITOR / OWNER MUST READ AND SIGN THE REVERSE SIDE OF THIS FORM.

*Clubs are eligible to offer mixed breed classes at agility trials beginning April 1, 2010.

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 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 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.

Mixed breed classes may only be offered at standalone all-breed AKC agility trials. A standalone agility event is defined as an agility trial that is not held on the same date and show site as an AKC All-Breed Dog Show or Independent Specialty for conformation. Dogs entered in the mixed breed classes must list the breed name as “mixed breed” and not as a breed hybrid.

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) 816-3776. 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? ______

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 above on 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 AGENT DULY AUTHORIZED TO MAKE THIS ENTRY TELEPHONE : E-MAIL ADDRESS:

Welsh Springer Spaniel Club of America Agility Trial~September 16, 2011 At Purina Farms, Gray Summit, MO Open to Welsh Springer Spaniels Only

Opens: 2.00 pm CDT Jan 1, 2010. Closes: 6:00pm CDT September 16, 2011. Mail entries with fees to: Betsie Czeschin, POB 1966, Mtn Home, AR 72654

Make Checks Payable to “WSSCA” Entry Fees: $15 each entry (incl AKC fee $3 per run)

STD JWW FAST

T2B

CATALOG $10.00

OFFICIAL AMERICAN KENNEL CLUB ENTRY FORM

Welsh Springer Spaniel Club of America Obedience #2011167014, Rally #2011167005 September 17, 2011 Purina Farms, Gray Summit, MO

Entry Fee: $20.00 each entry, each dog (includes AKC recording and event fees) ENTRIES CLOSE: 6 PM August 31, 2011 Checks payable to WSSCA, and mail to: Betsie Czeschin, POB 1966, Mtn. Home, AR 72654

Conditional, Unsigned or Incomplete entries or entries received without fees will not be accepted. Telephone or FAX entries are not acceptable. All cancellations must be written and received by the Show Secretary before closing date.

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 Welsh Springer Spaniel VARIETY 1 SEX

DOG 2, 3 SHOW

CLASS

CLASS 3 DIVISION Weight, color, etc

ADDITIONAL CLASSES

OBEDIENCE CLASS RALLY CLASS (Jump Height)

JR. SHOWMANSHIP CLASS

NAME OF (See Back) JUNIOR HANDLER (if any)

JR. HANDLER NUMBER

FULL NAME OF DOG

Enter Number Here

□ AKO REG NO.

□ AKC LITTER NO.

□ ILP NO.

□ FOREIGN REG NO & COUNTRY

DATE OF BIRTH

PLACE OF □ USA □ Canada □ Foreign

BIRTH

BREEDER

SIRE

DAM

ACTUAL OWNER (S) 4 (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 agent

duly authorized to make this entry

TELEPHONE #

E-MAIL Address (An acknowledgment or receipt of entry may he sent to this e-mail address)

AKC Rules, Regulations, Policies anda 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 to have been cause 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 forementioned 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 RO 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 EFFET 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

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. 3. (Dog Show Class) Consult the classification in this premium list. If the dog show 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 a show 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 name. State on entry form whether transfer application has been mailed to the AKC. (For complete rules, refer to Chapter 11, Section 3.)

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) 816-3776. 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? _________________________________________________________________________

AEAGL2 - (07/09)

OFFICIAL AMERICAN KENNEL CLUB ENTRY FORM

Welsh Springer Spaniel Club of America Entry Form for Hunting Test ~ Event #2011167015 September 19, 2011

Big River Hunt Club and Preserve, Fletcher, MO Entry Fee: $65.00 (Junior), $65.00 (Senior), $65.00 (Master) ENTRIES CLOSE: 8 PM, PST, September 7, 2011 Checks payable to WSSCA, and mail to: Betsie Czeschin, POB 1966, Mtn. Home, AR 72654

Conditional, Unsigned or Incomplete entries or entries received without fees will not be accepted. Telephone or FAX entries are not acceptable. All cancellations must be written and received by the Show Secretary before closing date.

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 Welsh Springer Spaniel VARIETY 1 SEX

Test Level Handler

NAME OF (See Back) JUNIOR HANDLER (if any)

JR. HANDLER NUMBER

FULL NAME OF DOG

Enter Number Here

□ AKO REG NO.

□ AKC LITTER NO.

□ ILP NO.

□ FOREIGN REG NO & COUNTRY

DATE OF BIRTH

PLACE OF □ USA □ Canada □ Foreign

BIRTH

BREEDER

SIRE

DAM

ACTUAL OWNER (S) 4 (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 agent

duly authorized to make this entry

TELEPHONE #

E-MAIL Address (An acknowledgment or receipt of entry will he sent to this e-mail address)

AKC Rules, Regulations, Policies anda 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 to have been cause 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 forementioned 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 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 EFFET 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.