WDA Trial Form

WDA Eastern Region Regional Trial

Hosted by: Sequoyah German Shepherds
Trial Date: October 21st - 23rd, 2022

(Trial starts at 9:00a each day).
Location: 1216 Thatcher Rd. Soddy Daisy, TN 37379
Fee Per Class:

$80.00 - ONLY Protection titles are offered at Regional trials
Judges: Brian Peterson and Barry Vradenburgh
Decoys: TBA
Entry Deadline: October 1st, 2022

(There will be a $20.00 convenience fee added for any entry submitted after the closing date. Entries will be limited.)
Contact: Shari Steven

Shari: 423-774-2611
Applicant Information:
Dog's Registered Name:
Dog's Call Name
Owner's Name *

First Name Last Name
Handler's Name - you can leave this field blank if the Owner is also the Handler.

First Name Last Name
Dog's WDA Registration *
Your dog must have a WDA number in order to compete. See info below if you do not have one.
If you do not have a WDA registration number, you will have to obtain it before completing this registration. All dogs must be registered with WDA one week prior to the trial date. A WDA registration number can be acquired at: WDA Registry Numbers
Breed

German Shepherd Dog Doberman Malinois Rottweiler Dutch Shepherd Bouvier
Sex

Male Female
Coat Color
Date of Birth *

Month Day Year
Date
Current Titles/Degrees
Sire's Name
Dam's Name
Owner's Address *

Street Address (Where pet will reside)

Mailing Address (If different than above)

City State / Province

Postal / Zip Code Country
Phone Number *

Area Code Phone Number
E-mail
example@example.com
ONLY CHOOSE ONE - you can only choose one of the titles listed below per entry form per dog.
Protection Sport Titles

PS1 PS2 PS3
Protection Titles

P1 P2 P3
Police Dog Titles

PD1 PD2 PD3
Is you dog eligible for an honor title at this trial

YES NO
Release:

I (we) the undersigned and all those who accompany me (us) hereby agree to waive and release Working Dogs of America, Sequoyah German Shepherds, its employees, officers, members, agents, all property owners of said event from any liability of any nature for loss, injury, or damage which i (we) or my dog(s) may cause or suffer while in/on the event grounds or near any entrance thereto to myself or my dog(s) and all those that accompany me to this event.
Signature *

Clear
Acknowledgements of Release:
Electronic Submission/Signature Acknowledgement By submitting this application electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully. I understand that untruthful answers or failure to comply with the requirements at this event can result in the forfeiture of entry fees and being removed from the event. I certify that the above information is correct, and I understand that the information will be verified.
Date *

Month Day Year
Legal name *
I understand that typing my name above constitutes a legal signature.
When paying for you enteries online, there is a small processing fee ($3.00 for each protection title). If you would like to avoid this fee, you can

1) Print this Form

2) Mail this form and your check to:

Sequoyah Shepherds

Attn: Shari Steven

482 Valley View Road

Dayton, TN 37321

Please make checks payable to Sequoyah Shepherds

(If you are unable to print out this form, go ahead and mail your check to the above address. When you complete your form, at the bottom of this page, hit "Save". You will be emailed a link to your form. You can then forward that email to SequoyahGSD@aol.com or you can copy and paste the "Shareable link" into a text message to 423-991-0979.)

Thanks!
My Products
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Police Dog Titles $ 80.00
If competing for a POLICE DOG TITLE, please select this option and choose one of the selections below.

Protection Sport Titles $ 80.00
If competing for a PROTECTION SPORT TITLE, please select this option and choose one of the selections below.

Protection Dog Titles $ 80.00
If competing for a PROTECTION DOG TITLE, please select this option and choose one of the selections below.

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WDA Eastern Region Regional Trial

Trial Date: October 21st - 23rd, 2022

Location: 1216 Thatcher Rd. Soddy Daisy, TN 37379

Fee Per Class:

Judges: Brian Peterson and Barry Vradenburgh

Decoys: TBA

Entry Deadline: October 1st, 2022

Contact: Shari Steven

Applicant Information:

Release:

Acknowledgements of Release:

Sequoyah Shepherds

Attn: Shari Steven

482 Valley View Road

Dayton, TN 37321