2023 AWMA IGP National Championship Entry Form

2023 AWMA IGP National Championship Entry Form
Dates: October 27–29, 2023

Location: Hendricks County Fairgrounds
1900 E Main St
Danville, IN 46122

Please fill out all the information carefully, and be sure to double check that everything is correct before submitting your entry. You will be required to attach a copy of your membership card, dog's scorebook, and proof of your dog's rabies vaccine in order to submit your entry. Additionally, online payment via credit or debit card will be required in order to submit your entry. If you have any questions or issues with this form, please email us at ccdtindy@gmail.com or message us on Facebook.

Fields marked with a red asterisk (*) indicate the field is required in order to submit the entry form.

To save your progress and return later, scroll to the bottom of the form and click the "SAVE PROGRESS" button.

*** NO REFUNDS ON ENTRY FEES ***
Handler Information:
Handler Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Membership Number*
Membership Expiration Date*

MonthDayYear
Date
Region*
Yes
Yes
Dog Information:
Dog's Registered Name*
Dog's Call Name*
Dog's DOB*

MonthDayYear
Date
Dog's Sex*
YesNo
Microchip/Tattoo Number*
Dog's Registration Organization*
Example: AKC
Dog's Registration Number*
Scorebook Organization*
Scorebook Number*
HOT? BHOT?*
I am the owner as well
Owner Information

Only complete this section if the owner of the dog is different than the handler.
Owner Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Membership Number
Membership Expiration Date

MonthDayYear
Date
Title Information
IGP 3IGP 2IGP 1
Upload a Copy of Membership Card, Scorebook, & Rabies Vaccine
Please upload a copy of your membership card here:*
Please upload proof of your dog's titles in your scorebook here:*
Please upload proof of your dog's rabies vaccine here:*
Upload a Photo of You & Your Dog
Upload Photo (will be used for website & catalog)
Draw Night Dinner
Will you need dinner following the draw?*
A complimentary BBQ dinner will be served immediately following the draw. Since we're doing draw night a little differently where people don't necessarily have to stick around for dinner after the draw, we need to know if you'll be participating in the dinner.
Waiver of Liability
Please read the following Waiver of Liability
I Accept
Signature*

Clear
Parent/guardian must sign for minors under 18 years of age.
Today's Date*

MonthDayYear
Date
Payment of Entry Fee
Card types accepted: Visa, MasterCard, American Express, Discover, Diners Club, JCB

Entry Fee*

AWMA Entry

$300.00 Quantity

Enter coupon

Total

$0.00

Credit/Debit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

*** NO REFUNDS ON ENTRY FEES ***

All participants understand that Controlled Chaos Dog Sports, LLC, has no control over extreme weather, acts of God, acts of terrorism, governmental intervention, or any other cause that may prevent, alter or interrupt the event weekend. We will not refund fees due to extreme weather, acts of God, acts of terrorism, or governmental intervention. Announcements regarding cancellation of the event will be made on the event Facebook page.
Should be Empty:

2023 AWMA IGP National Championship Entry Form

Handler Information:

Dog Information:

Owner Information

Title Information

Upload a Copy of Membership Card, Scorebook, & Rabies Vaccine

Upload a Photo of You & Your Dog

Draw Night Dinner

Waiver of Liability

Payment of Entry Fee