2021 USMRA Club Trial Request Form

2023 USMRA Club Trial Request Form

Requests must be submitted 60 days prior to date of trial.

Club Name Hosting Trial*

Additional Club Name Hosting Trial

Location where trial will be held*

Event website and/or Facebook page url

Please verify that the trial will be held at a location that meets the criteria for field size (60m x 40m). Any changes to location MUST be approved by the Board of Directors in order for the trial to be held.

Yes, meets field size requirementsNo, does not meet field size requirementsDo not yet have a location for the trial

Trial Date Start*

MonthDay Year

Trial Date End*

MonthDay Year

Trial Theme*

Will there be open field available prior to this trial?*

YesNo

Date and time of Open Field

MonthDay Year Hour Minutes AM/PM Option

Judge Requested*

Decoys Requested*

Deputy Judge*

Judge's Secretary*

Trial Secretary*

Contact Person*

First Name Last Name

Contact Phone

Area Code Phone Number

Insurance Company for Club Insurance. If none, state USMRA. Insurance Certificate Request must be submitted*

Insurance Person Contact Info

Please consider using the electronic scoresheets.

Need Score sheets? Complete number needed*

YesNo

Brevet

MR 1

MR 2

MR 3

OB/OBJ (Obedience Only)

USMRA Evaluation of Working Aptitude/Sociability Test

Entry fee for Sociability Test*

Entry fee for OB/OBJ*

Entry fee for Brevet, MR1,MR2, MR3*

Email address to send Trial Entry form submissions*

Do you want a Paypal link on your Trial Entry Form*

YesNo

If PayPal link is desired, please provide PayPal account email address

By submitting this document, this club and it's members and agents agree to abide by USMRA by-laws, USMRA Code of Conduct and policies and procedures. We also agree to notify USMRA Secretary in writing of any changes, and event incidents and procedure deviations to be included in returned trial report summary, which will be sent in two weeks or less after event. USMRA is committed to an anti-discrimination policy in all of its programs. Membership entitles all members in good standing to attend all USMRA sanctioned events. We agree to be responsible for procuring insurance coverage either through USMRA or private club policy.*

Agree

Signature*

Date*

Date

Comments, questions and feedback

Copy of Insurance Policy if Individual Club Policy