Trial-Scentwork AKC Trial Entry Form, October 17

Please choose which class(es) you want to enter SATURDAY OCTOBER 17 TRIAL #1

Please choose which class(es) you want to enter SATURDAY OCTOBER 17 Trial #2

Please choose which class(es) you want to enter SUNDAY OCTOBER 18 TRIAL #1

Please choose which class(es) you want to enter SUNDAY OCTOBER 18 TRIAL #2

Enter Dog's AKC Registration Number

Enter Dog's Call Name

Enter Dog's Registered Name & Titles

Dog's Date of Birth

Date

Dog's Gender

Indicate Breed or All American

Please Select ONE type of AKC Registration:

Indicate Variety if applicable

Enter Breeder Name (Pure Bred ONLY)

Enter Sire's Name /Titles (Pure Bred ONLY)

Enter Dam's Name /Titles (Pure Bred ONLY)

Owner's Name

First NameLast Name

Owner's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Owner's Email (confirmation will be sent to this email)

example@example.com

Owner's Cell Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Co-Owner's Name if applicable

Is Owner the Handler for this dog?

Handler Name (ONLY if different than owner)

First NameLast Name

Handler Day of Trial Phone Number (ONLY if different than owner)

Please enter a valid phone number.Format: (000) 000-0000.

Emergency Contact Name for Handler/Owner on Day of Trial

First NameLast Name

Emergency Contact Mobile Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Is Handler a Junior under 18 years of age?

For JUNIOR Handlers ONLY: Please insert ID# Should you not have your Junior Handler number, this may be obtained from the American Kennel Club. (Phone) 919-816-3770 or juniors@akc.org

Jr Handler ID#

Jr Handler Relationship to Dog's Owner

Jr Handler Date of Birth

Date

Jr Handler Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

By signing the entry form, we certify that the Junior Showman does not now, and will not at any time, act as an agent/handler for pay while continuing to compete in Junior Showmanship

GENERAL AKC 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 there from, 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 ATTENDANCE 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 BYARBITRATION PURSUANT TO THE APPLICABLE RULES OF THE AMERICAN ARBITRATION ASSOCIATION.
HOWEVER, PRIOR TO ARBITRATION ALL APPLICABLE 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
1. (Variety) if you are entering a dog of breed in which there are varieties for show purposes, please designate the
particular variety you are entering, i.e., Cocker Spaniel (solid color black, ASCOB, parti-color), Beagles (not exceeding
13 in., over 13 in. but not exceeding 15 in.), Dachshunds (longhaired, smooth, wirehaired), Collies (rough, smooth),
Bull Terriers (colored, white), Manchester Terriers (standard, toy), Chihuahuas (smooth coat, long coat), English Toy
Spaniels (King Charles and Ruby, Blenheim and Prince Charles), Poodles (toy, miniature, standard).
2. The following categories of dogs may be entered and shown in Best of Breed competition: Dogs that are
Champions of Record and dogs which, according to their owners’ records, have completed the requirements for a
championship, but whose championships are unconfirmed. The showing of unconfirmed Champions in Best of Breed
competition is limited to a period of 90 days from the date of the show where the dog completed the requirements for a
championship.
3. (Event Class) Consult the classification in this premium list. If the event class in which you are entering your dog is
divided, then, in addition to designating the class, specify the particular division of the class in which you are entering
your dog, i.e, age division, color division, weight division.
4. A dog must be entered in the name of the person who owned it at the time entries for an event closed. If a
registered dog has been acquired by a new owner it must be entered in the name of its new owner in any event for
which entries closed after the date of acquirement, regardless of whether the new owner has received the registration
certificate indicating that the dog is recorded in his name. State on entry form whether transfer application has been
mailed to the AKC. (For complete rules, refer to Chapter 11, Section 3.)

____________________________________

Signature

I CERTIFY that I am the actual owner of the dog, or that I am the duly authorized agent of the actual owner whose name I have entered above. In consideration of the acceptance of this entry. I (we) agree to abide by the rules and regulations of The American Kennel Club in effect at the time of this show, obedience trial and/or agility trial, and by any additional rules and regulations appearing in the premium list for this show, obedience trial and/or agility trial, and further agree to be bound by the “Agreement” printed on the reverse side of this entry form. I (we) certify and represent that the dog entered is not a hazard to persons or other dogs. This entry is submitted for acceptance on the foregoing representation and agreement. SIGNATURE of owner or his agent duly authorized to make this entry.

Purchase Runs Selected

Number of TOTAL classes entered for OCTOBER 17 & 18, 2026

$27.00 Quantity
Item subtotal:

Convenience On-Line Processing Fee

Non-Refundable

$4.00

Total

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

AKC OFFICIAL ENTRY FORM

Staten Island Companion Dog Training Club, Inc

THIS FORM IS FOR ON-LINE ENTRIES ONLY ($4 NON-REFUNDABLE PROCESSING FEE INCLUDED) ENTRIES OPEN SEPT 10, 2026 at 8:00AM* (*Entries received before opening DATE & TIME are invalid) ENTRIES CLOSE SEPT 30, 2026 8:00PM

Purchase Runs Selected

Payment Methods