2022 BCOSW Specialty Entry Form

Payment

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BASENJI CLUB OF SOUTHEASTERN WISCONSIN, INC.
WESTERN WAUKESHA COUNTY DOG TRAINING CLUB
W1314 CEDAR DRIVE, IXONIA, WI 53036
FRIDAY, JULY 29, 2022

ENTRY FEES: $30.00 for all Conformation classes except for the Puppy and Bred-By Exhibitor classes which are $25.00. All nonregular class entries are $25.00 (includes Sweepstakes, Veteran classes, Stud Dog/Brood Bitch) Junior Showmanship not offered.

CLOSING DATE for all entries 6:00 pm Wednesday, July 13, 2022 at Show Secretary’s Office after which time Entries Cannot be Accepted, Cancelled or Substituted except as provided for in Chapter 11, Section 6 of the Dog Show Rules.

MAIL ALL ENTRIES with fees to: Clay Bunyard, 373 Arbor Vitae Ln, DePere, WI 54115
MAKE CHECKS and MONEY ORDERS payable to Basenji Club of Southeastern Wisconsin (BCOSW)

IMPORTANT —Read carefully instructions at the end of the form before filling out. Numbers in the boxes indicate sections of the instructions relevant to the information needed in that box

I enclose $____ for entry fees. CANADIAN EXHIBITORS must make fees payable in U.S. Funds. *

enter $ amount

Breed

Sex *

DOG (2,3) SHOW CLASS *

Regular and Non-Regular Classes

CLASS (3) DIVISION Weight, Color, Etc.

Indicate color for open classes

ADDITIONAL CLASSES 1

Sweepstakes

ADDITIONAL CLASSES 2

Stud Dog, Brood Bitch

FULL NAME OF DOG *

AKC titles only

Registration *

AKC REG NO. PAL/LP NO FOREIGN REG NO & COUNTRY

Enter Number Here *

DATE OF BIRTH *

Date

PLACE OF BIRTH *

BREEDER *

SIRE *

AKC titles only

DAM *

AKC titles only

ACTUAL OWNER(S) *

OWNER'S ADDRESS *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

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 foregoingrepresentation 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/her agent duly authorized to make this entry: *

Clear

TELEPHONE NUMBER *

Area Code Phone Number

Are you a new exhibitor? *

Owner Handled Eligible? *

Email Address *

example@example.com

Upon submission of this form please go to our club website to pay and for your entries to be complete. You will receive a confirmation email acknowledging your entry.

AKC Rules, Regulations, Policies and Guidelines are available on the American Kennel Club website: 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 forementioned 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

(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).
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.
(Event Class) Consult the classification in this premium list. If the event 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.
A dog must be entered in the name of the person who actually owned it at the time entries for an event 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/her name. State on entry form whether transfer application has been mailed to the AKC. (For complete rules, refer to Chapter 11, Section 3.)
Mixed Breed dogs entering classes for Agility, Obedience, and Rally trials should mark Breed as “All-American Dog/Mixed Breed.” Sire and Dam information shall remain blank for mixed breed entrants.