BGDS May 2021

The Commonwealth of Kentucky Department of Revenue has notified BGDS that we must collect tax of 6% on all entries.

Owner's Name *

First Name Last Name

Handler's Name (if different)

First Name Last Name

Email *

example@example.com

I have entered a BGDS trial since September 2018.

YES (Proceed to Dog Information if no contact information has changed) No (please fill in all contact information to complete your entry)

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number

Area Code Phone Number

Emergency Contact Name

First Name Last Name

Emergency Contact Phone Number

Area Code Phone Number

Dog Information

Dog's Registered Name *

Call Name *

Barn Hunt Number *

BH- is required

This dog has entered a BGDS trial since September 2018.

YES (proceed to class selection) NO (please fill in ALL information to complete your entry)

Sex

Male Female

Dogs breed (or mixed breed)

Height in inches

Height Division

Small Medium Large

Date of Birth (or approximate)

Date

Class Selection

All classes should be entered in the following division: (If you are unsure of the division to enter please refer to the BHA rule book)

A B

Wednesday Trial 1 Regular Classes *

Wednesday Trial 1 Additional Classes *

Wednesday Trial 2 Regular Classes *

Wednesday Trial 2 Additional Classes *

Thursday Trial 2 Additional Classes *

Friday Trial 1 Regular Classes *

Friday Trial 1 Additional Classes *

Friday Trial 2 Regular Classes *

Friday Trial 2 Additional Classes *

Saturday Trial 1 Regular Classes *

Saturday Trial 1 Additional Classes *

Saturday Trial 2 Regular Classes *

Saturday Trial 2 Additional Classes *

Sunday Trial 1 Regular Classes *

Sunday Trial 1 Additional Classes *

Sunday Trial 2 Regular Classes *

Sunday Trial 2 Additional Classes *

Monday Trial 1 Regular Classes *

Monday Trial 1 Additional Classes *

Monday Trial 2 Regular Classes *

Monday Trial 2 Additional Classes *

Total Entry Fees

Online processing fee

Ky Sales Tax

Total Amount Due

Total Due

USD

RELEASE AGREEMENT FORM Certification of Agreement upon Registration or Entry of Dog 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 Barn Hunt Associations, LLC 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 liability waiver enclosed with my entry. I (we) certify and represent that the dog entered is not a hazard (dog or human aggressive) 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 Barn Hunt Association, LLC Rules and Regulations and to abide by any decisions made in accord to them. Liability Waiver I (we) agree that Bluegrass Dog Sports 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 win prizes, ribbons, and/or trophies, I (we) agree to hold Barn Hunt Association, LLC, Bluegrass Dog Sports, their members, directors, governors, officers, agents, 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 BHA LLC 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 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 there from, 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 cause 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 hereby authorize club-appointed videographer and/or photographer to use, reproduce, and/or publish photographs and/or video that may pertain to me, including my image, likeness and/or voice without compensation. I understand that this material may be used in various publications, public affairs releases, recruitment materials, the BHA LLC website, the Bluegrass Dog Sports web site, yahoo group or Facebook page, or for related endeavors. This authorization is continuous and may only be withdrawn by my specific rescission of this authorization. I have read the above. Signature of owner or his agent dulyauthorized to make this entry: *

May 2021 BGDS Entry Form