akc_agility

CLUB NAME
INITIALS
Trial Opening Date and Time (CT)

MonthDayYear
Date
Hour MinutesAM/PM Option
Current Date

MonthDayYear
Date
Current Time (CT)

Hour Minutes
Show/Trial Dates*
Day 1 - DATE
Day 2 - DATE
Day 3 - DATE
Day 4 - DATE

	STD	JWW	FAST	T2B
Check all Classes you are entering.

	STD	JWW	FAST	T2B
Check all Classes you are entering.

Owner Information
PRIMARY Owner Name*
Check this box if Junior Handler Eligible

Yes I am a Junior Handler
ADDITIONAL Owner's
IF dog is Co-Owned... list all co-owners.
Address*
City*
State / Province*
Zip Code*
Check box if this a New Address!

NEW ADDRESS
Phone Number*
Email*
example@example.com
Check this box if this is a New Email!

New Email
HANDLER - If different from Primary Owner
If different from PRIMARY Owner

AKC Rules, Regulations, Policies and Guidelines are available on the American Kennel CLub Web Site, 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 aforementioned 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 ATTEN DANCE 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 APPLICA BLE 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

Handlers whose dogs measure into the 8" through 20" regular jump height divisions may opt to enter in a hight or 24-choice height division for all Regular titling classes, but not in a division lower thantheir proper height division. Dogs who measure into the 24" regular jump height division may not ener 24-choice. Dogs entered in the Preferred classes must compete at the required jump height and may not compete in a jump height division higher or lower than their proper height division.

All dogs that have not been officially measured for an Agility Jump Height Card may still compete; however, they must be measured by a Judge of record, an Agility Field Representative, or a Volunteer Measuring Official, prior to running. If measured by the Judge of record, that measurement will be valid for this trial or back-to-back trials only. If a measurement is necessary, it is the exhibitor’s responsibility to have their dog(s) measured prior to running.

Dogs listed in the AKC Canine Partners Program^SM may be eligible to enter all-breed AKC agility trials at the club’s option. These dogs should be listed as All American Dog and must include their AKC number on the entry form and check the AKC No. box.

Junior Handler Information

If Jr. Handler is checked on page 5, required information will be shown here.
JR. HANDLER NAME*
ENTER JR. HANDLER # if applicable*
Jr Handler DATE OF BIRTH*

MonthDayYear
Date
RELATIONSHIP TO OWNER
Fill this out IF Jr. Handler is NOT the owner of the dog.
Junior Handler Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Junior Handlers should enter their Junior Handler Number on the this form. Should you not have your Junior Handler Number, it may be obtained from the American Kennel Club (919) 233-9767. If the Junior Handler is not the owner of the dog identified on the face of this form, what is the rlationship of the Junior Handler to the Owner?

Signature and Payment information
SIGNATURE of owner or his agent duly authorized to make this entry. (Use your mouse to sign form)*

Clear
In Case of Emergency - Name*
Emergency Contact Phone #*
TOTAL CLUB Entry Fees
TOTAL ONLINE Entry Fees
TOTAL AMOUNT OWED

prevnext( X )
USDThis is the amount you will be charged for your dog's NEAA Agility entry. IT INCLUDES THE NON-REFUNDABLE ONLINE ENTRY CHARGES.

Should be Empty:

Dog Information

The Registration # "Letters" MUST be CAPITALIZED for Auto Complete to work!

Classes Entering

CLASS LEVEL/HEIGHT

Owner Information

Junior Handler Information

Signature and Payment information