NBSC Trial Entry Form

TRIAL ENTRY FORM
TRIAL DATE:

December 13, 2025

TRIAL LOCATION:

NBSC Training Field 9170 SC-90, Longs, SC 29568

JUDGE:

Ray Jeffers

HELPER: TBD
HANDLER INFORMATION
Full Name:
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
City, State, Zip:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone/Cell:
Email:
example@example.com
Handler Organization
Handler Membership # and Expiration Date
USCA Club/Date where handler received BH
Dog Owner (if same as handler, enter "same"):
Dog Owner Email
example@example.com
Dog Owner Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Dog Owner Phone #
Dog's Full Name (as written in scorebook)
M/F:
Dog's Breed:
Present Titles:
USCA/FCI Scorebook No:
Dog Birthdate:

MonthDayYear
Date
Handler/Owner Trained? Y/N:
Registration #
Microchip or Tattoo #:
TRIAL ENTRY FEES (Include payment when submitting this form.)

Checks made out to "Chris Thompson-club account" and mailed to 9170 SC-90 Longs, SC 29568

PayPal @JaQuasiaC (jrchaires23@gmail.com)

Venmo @northbeachschutzhund (JaQuasia Thompson)

Please enter an "X" indicating the titles you are entering:
Trial Entry Fees Titles

BH $75IGP 1 $90IGP 2 $90IGP 3 $90Non-USCA member $50
PLEASE READ THE STATEMENTS BELOW AND SIGN:

It is hereby understood that every dog at this event will be under the direct care and control of its handler. The undersigned agrees to be fully responsible for any and all actions of their dog including dogs owned by another but in the undersigned's care. The undersigned agrees to hold harmless all members, officers and directors of North Beach Schutzhund Club, the United Schutzhund Clubs of America, and any property owners associated with this event in case of an accident, injury, loss, or incident that may occur on or near the trial grounds, before, during or after the event. Handlers/owners agree to abide by all rules of United Schutzhund Clubs of America.

I hereby assume all responsibilities and liabilities for my dogs and myself, and agree to abide by all USCA guidelines and the rules set forth for this trial by North Beach Schutzhund Club and/or the trial judge.
SIGNATURE:

Clear
DATE:
Should be Empty:

TRIAL ENTRY FORM