NADAC Entry Form

NADAC Trial Nov 2 - 3, 2024

PayPal entries only.
Form will open for entries on Sept 16, 8 AM
Date

MonthDayYear
Date
Time

Hour Minutes

AM/PM Option
How many dogs are you entering?*
You may include up to 3 dogs on this entry.
Dog #1 Entry
Owner's Name
Handler's Name, if not Owner
Owner's Email
example@example.com
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState

Zip Code
Emergency Contact Name
Emerg Contact's Tel
Please enter a valid phone number.
Call Name Dog1
NADAC #
Breed Dog1
Date of Birth

MonthDayYear
Date
Height At Withers
Category

ProficientSkilled
Division Dog1 (select only 1)

StandardVet DogVet HandlerJr Handler
Desired Jump Height Dog1

48121620
Select the level at which your dog performs (Intro, Novice, Open, or Elite) for each class.

Dog1 Sat. Nov 2/24

Dog1 Sun. Nov 3/24

Dog1 #Runs Nov 3/24
Total # of Runs - Dog1
In consideration of the acceptance of this entry, I/we certify that I/we have knowledge of, and are familiar with, and agree to abide by, the Rules and Regulations of NADAC in effect at the time of this trial, and by any additional rules and regulations as approved by NADAC for this trial. I/we certify that the dog entered is not a hazard to persons or other dogs. I/we further agree to by bound by the “Agreement” printed on page 5 of the premium.
I/we agree.

Yes
Signature *

NADAC Trial Nov 2 - 3, 2024