Stoneleigh Rally Challenge Awards Purple Submission

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Which Challenge Board are you submitting for?*

Handler's Name *

(As you want it to appear on your certificate)

Age (if between 10 and 18)

Type a question

If under 16 years of age I confirm that I have my parent's permission to apply for this award

Dog's Pet Name*

Dog's Registered Name

(Optional)

Breed of Dog

Dog's Age (in years and months, months only for 18 months and under)*

Puppies must be 4 months old to take part

Email*

example@example.com

Please tell us where to send your award:

Street Address

Street Address Line 2

TownCity/County

Postal / Zip Code

Country

(If not UK - please ensure you pay the overseas fee)

Activity 1*

Activity 2*

Activity 3*

Activity 4*

Activity 5*

URL Link for your video or playlist*

We recommend using a service such as YouTube to upload your videos

Do you have any notes regarding your submission?

I wish to apply for the above Stoneleigh Rally Purple Challenge Award. I will respect the decisions of the Assessors. I understand that only one square can be be resubmitted FOC and after that I will have to pay a resubmission fee*

I agree

Signature*

(Please type your name in the box to electronically sign this form. )

My Products

UK Submission FeePurple Submission Fee - UK rate

£12.00

Overseas Submission FeePurple Submission for non-UK residents. NOTE - if you would rather have a digital certificate without Award ribbon please choose the UK rate.

£14.50

Enter coupon

Total

£0.00

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Once you have clicked the "Submit" button it will take you to a "Thank you" page. If you don't see this page make sure you have filled in all the required fields (marked with a red asterix).

Alternative Payment

I have pre-paid or I don't have PayPal and will contact Stoneleigh Rally for payment details, I understand that my submission is not confirmed until my fee is received.

Purple Submission Form

Unfortunately you have to be 10 or over to take part in our awards

Please enter the square numbers you have filmed.