UKC Coursing Entry Form

OFFICIAL UNITED KENNEL CLUB COURSING ENTRY FORM
UKC
HOST CLUB
Date

MonthDayYear
Date
Above Date's Trials

Trial 1Trial 2
Date

MonthDayYear
Date
Above Date's Trials

Type option 1Type option 2
Date

MonthDayYear
Date
Above Date's Trials

Trial 1Trial 2
Date

MonthDayYear
Date
Above Date's Trials

Trial 1Trial 2
Dog's Registration Type

UKC Permanent RegUKC TLUKC (PL/LP)
Registration Number
Breed
Dog Height at Withers
Dog's Name
Sex
Call Name
Date of Birth

MonthDayYear
Date
Junior Name
Junior #
Dog Owners Name
Address
City
State/Providence:
Postal Code
Phone Number
Email
example@example.com
PC DIVISION
Type a question

NoviceAdvancedSuperiorMasterEliteDashSteeplechaseFun RunSteeplechase
Signature of OwnerHandler

Clear
Date

MonthDayYear
Date
If owner is a minorSignature of Parent or Guardian

Clear
Date

MonthDayYear
Date
Should be Empty:

UKC