PSA TRIAL Entry Form

Full Name*

First NameLast Name

PSA Member Number*

Phone Number*

E-mail*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Country (if not USA)

K9's Name*

K9's Breed*

K9's Age*

Owner Trained*

Do You Have a Scorebook for this K9?*

Scorebook must be presented to registration on trial day or pay $35 replacement fee. If you have never received a scorebook for this dog, you may purchase one for $10 from psak9.org. Replacement scorebooks may be purchased ahead of time from psak9.com for $35

Scorebook Number*

Signature (type name as signature)*

RELEASE: It is the understanding that the above handler / dog team are entering this trial AT THEIR OWN RISK. I understand that serious accidents can and do occur during dog training, competitions and other dog related events / activities. I am assuming all risk, liabilities and responsibilities and will hold harmless PSA, U-Tang K9, Golden State PSA, their agents, partners, employees, sponsors from ANY AND ALL liability arising from this dog-related event and practice training while at 12943 700 E, Draper, UT 84020. I also agree to hold harmless any of the above mentioned from any property damage, theft, death or personal injury to my dog or myself. I also agree to have complete control over myself and my dog(s) at all times. By signing this entry form I acknowledge that I have read and understood the trial waiver and read and understand all PSA rules that govern trials. There will be no refunds given to any handler that has been ejected from this trial for any reason. In addition, by signing (typing in your name as a signature) this release I give consent to any representative of PSA, U-Tang K9, Golden State PSA to take pictures of events and any activities surrounding the events, said pictures shall be the sole and exclusive property the authorized photographer for their sole and exclusive use and distribution. Further, by signing this, I release any rights to the sale, posting or distribution of any pictures taken by the authorized event photographer and waive any right to remuneration or compensation for any media taken or sold for the events in question.

Competition Entry Form

Entry Fee Payment