Western KY Schutzhund Club

Western KY Schutzhund Club
UDC Fall 2022 Trial

November 5-6, 2022, Judge Bogdan Sergo
Handler Information:

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Club Affiliation:
UDC Membership#
Dog’s Name:
Male or Female:

MaleFemale
DOB:
Breed:
Owner (If other than handler)
Registration# (AKC/ Other)
Scorebook #
Microchip #
Existing Titles:
Select Entry Title(s)

BH $75.00IGP1 $100.00IGP2 $100.00IGP3 $100.00
I certify that I am the actual owner of this dog or I am duly authorized by the owner of this dog to act as his/her agent and the dog's handler. In consideration of acceptance of this entry, I agree to abide by the rules of the Western KY Schutzhund Club and follow all instructions issued by the Trial Judge. I further agree to indemnity and hold harmless the Western KY Schutzhund Dog Club, it's officials,individual members, along with the owners of any premises on which the event is held, from any and all claims made as a result of any action by any individual or dog, including the dog I am handling.
Signature

Clear
Email
example@example.com
Date

MonthDayYear
Date
Should be Empty:

UDC Fall 2022 Trial