OHCA PEC Event Application

Otterhound Club of America, Inc. Application to Host the OHCA Public Education Event
This application is intended to collect information regarding an event hosted on behalf of the Otterhound Club of America, inc. to assure coverage through the OHCA Liability Insurance.
This Application is for: *

Meet The Breed Fun Day Breed Education Tracking/Nose Work
Year of the Event: *

2021 2022 2023 2024 2025 2026
Event Location *

City State
Event Start Date *

Month Day Year
From
Event End Date *

Month Day Year
To
Additional Information about the Event:
This Proposal is Submitted by:
Event Chair/Main Point of Contact *

First Name Last Name
Event Chair - Email *
example@example.com
Event Chair - Phone Number *

Area Code Phone Number
Event Co-Chair/2nd OHCA Member

First Name Last Name
2nd Member - Email
example@example.com
2nd Member - Phone Number

Area Code Phone Number
OHCA Members That Will be Present at the Event:
First & Last Name(s)
Number and Names (if available) of Otterhounds expected at the Event:
Dog Name(s)
Additional Comments/Information
Are there any costs associated with the Event? *

No Yes - Please explain below
Cost Explanation/Funding Request
This Application will be submitted to Cindy Huffman. Please keep a copy for your records.
Please verify that you are human *
Should be Empty: