Brick City Working Dog Club IGP Trial & Show

Brick City Working Dog Club IGP Trial & Show

January 27-29, 2023 Entries due by 1/20/23
Handler Information
Handler Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
USCA Membership Number & Expiration Date
Owner Information

*If different from handler*
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
USCA Membership & Expiration Date
Dog Information
Dog's Registered Name
Breed
Male/Female
Dog's Date of Birth
Dog's Registration Number
Tattoo/Microchip Number
Sire's Name & Registration Number
Dam's Name & Registration Number
Handler Owner Trained or Breeder Handler Owner Trained
Scorebook Organization & Number
Previous BH by Handler (location & date)
Please select all that apply

BH VT $75IGP 1 $100IGP 2 $100IGP 3 $100AD $75Breed Survey $150Puppy 4-6 Months $50Puppy 6-9 Months $50Puppy 9-12 Months $50Youth 12-18 Months $60Youth 18-24 Months $60Adult Untitled $75Working $75Veteran $75
Is this a new breed survey?

YesNo
Is the dog entered a Long Stock Coat?

YesNo
Entry fees must be sent via PayPal to brickcitywdc@gmail.com. Please send as a "Friends and Family" payment. Include handler and dog name in notes.

Non USCA members, please add an additonal $25 per entry fee.
RELEASE STATEMENT: It is understood that every dog at this event will at all times be in the care and control of the dog’s handler. It is further understood that the undersigned agrees to be fully responsible for the actions of his/her dog(s) while on the trial grounds. I agree to hold Brick City Working Dog Club, as well as its members, officers, directors, and all property owners HARMLESS for loss or injury which may have allegedly been caused directly or indirectly to any person or thing by any act of my dog(s) or to my dog(s) while on the trial premises. I hereby assume all responsibility and liability for such claims. I further relinquish all claims and agree to hold Brick City Working Dog Club, as well as its members, officers, directors, and all property owners HARMLESS for loss or injury which may have allegedly been caused directly or indirectly to myself or my dog(s) during attendance in and participation in this event.
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Brick City Working Dog Club IGP Trial & Show

Handler Information

Owner Information

Dog Information