AKC FDC - Farm Dog Certification Test - 4 Day Event Entry form- October 2

Texas Farm Dog Training Group Registration Form

AKC FARM DOG CERTIFICATON TEST
LOCATION
DATE

MonthDayYear
Date
AKC FARM DOG CERTIFICATON TESTS WILL TAKE PLACE

THURSDAY, OCTOBER 2 THROUGH SUNDAY OCTOBER 5, 2025

LOCATON: HUMBLE CIVIC CENTER, 8233 WILL CLAYTON PARKWAY, HUMBLE, TEXAS

ALL DOGS MUST BE 9 MONTHS OLD AT TIME OF TESTING
PAYMENT INFORMATION: PAYMENT MUST BE RECEIVED IN ADVANCE. THANK YOU

Make checks payable to :

Cindy Wildman, P.O. Box 1162, League City, Texas 77573

Paypal link: https://www.paypal.me/@AmLureCourseRacing

Venmo link:@Cynthia-Wildman-AmLureCourse

ZELLE:Cynthia Wildman-832-671-3793

When using PayPal or Venmo please choose friends and Family.
PAYMENT TYPE: Choose which payment type you are sending.

PayPal: Link https://www.paypal.me/@AmLureCourseRacingVenmo Link:@Cynthia-Wildman-AmLureCourseZelle: Cynthia Wildman - 832-671-3793Check
PAYMENT AMOUNT"
Each Test is $45.00. 2 Test are Required to receive your FDC Title. Limited space available. Dogs Must by 9 month old at time of AKC Testing

THURSDAY- TEST #1 ($45.00)THURSDAY- TEST #2 ($45.00)FRIDAY- TEST #3 ($45.00)FRIDAY- TEST #4 ($45.00)SATURDAY- TEST #5 ($45.00)SATURDAY- TEST #6 ($45.00)SUNDAY- TEST #7 ($45.00)SUNDAY- TEST #8 ($45.00)
Full Name of Dog
Dogs Call Name:
Breed
Date of Birth

MonthDayYear
Date
Sex
AKC/PAL/CD-Companion Dog Number
Owners Name
Address

Street Address

Street Address Line 2

CityState

Zip Code
Phone number
Email
example@example.com
I hereby certify that I am the Owner/Agent of this dog and (I) we will abide by the rules and regulations of Texas Farm Dog Training Group at the time of this Clinic/Class/Test. (I) we acknowledge that the dog entered is not a hazard to any people or their dogs. (I) we agree that American Lure Course Racing has the right to refuse this entry for cause of which may be deemed sufficient. (I) we agree not to hold TFDG and/or its workers responsible for any harm from any claim for loss or injury which my be alleged to be caused directly or indirectly by my dog at this event. (I) we will assume all responsibilities and liabilities of my dog that causes harm or injuries from a loss, injury or damage to this dog or any other dog or person at this event. I have read and(I) we agree to this statement.
Signature and release of Owneragent

Clear
Signature and release of Owner/agent: I understand and I have read the release form above.
Date

MonthDayYear
Date
How did you learn of our event
Should be Empty: