OFFICIAL AMERICAN KENNEL CLUB ENTRY FORM FOR AGILITY TRIAL
— Gallatin Dog Club —

Entries close at 6:00 pm Wednesday May 20, 2009 or when limit is reached.
Entries must be correctly completed & signed by the dog’s owner or the owner’s duly authorized agent.
Fill in the form & print in Internet Explorer - Firefox is not printing the text fields. In print preview, size the page to 80%before printing.
Mail entries with checks payable to GDC to: Samie Jones, Trial Sec’y, 721 W Cameron Bridge Road, Bozeman, MT 59718.
Fees: Each class, $17 includes $3 AKC recording fee Please mark the classes you are entering:

								Fees per day:
Friday	06/05/2009		Standard		JWW		FAST	$
Saturday	06/06/2009		Standard		JWW		FAST	$
Sunday	06/07/2009		Standard		JWW		FAST	$

Catalog pre-order ($5.00) $           Total Fees enclosed $

(IMPORTANT: CAREFULLY READ INSTRUCTIONS ON REVERSE SIDE BEFORE FILLING OUT)
BREED		VARIETY		SEX Male Female	HEIGHT AT WITHERS
STANDARD AGILITY CLASS None Nov A Nov B Open Excellent A Excellent B		JUMPERS WITH WEAVES None Nov A Nov B Open Excellent A Excellent B		FAST None Nov A Nov B Open Excellent A Excellent B
PREFERRED AGILITY CLASS None Novice Open Excellent A Excellent B		PREFERRED JWW None Novice Open Excellent A Excellent B		PREFERRED FAST None Novice Open Excellent A Excellent B
REGULAR JUMP HEIGHT 8" 12" 16" 20" 24"			PREFERRED JUMP HEIGHT 4" 8" 12" 16" 20"
NON-REGULAR AGILITY CLASSES: (If offered)		INT'L SWEEPSTAKES CLASS:      STD      JWW		JUMP HEIGHT (circle) 14      18      26
AKC REGISTERED NAME (Include AKC titles only)			CALL NAME OF DOG
REGISTRATION NO. AKC Reg. No. AKC Litter No. ILP No. Foreign Reg. No. & Country		DATE OF BIRTH PLACE OF BIRTH USA Canada Foreign		AKC Junior Handler #
BREEDER
SIRE			DAM
ACTUAL OWNER(S)
OWNER’S ADDRESS       ( New Address?)
HANDLER (Junior Handler – see other side)			Jump Height Card is attached Dog needs to be measured
I CERTIFY that I am the actual owner of the dog, or that I am the duly authorized agent of the actual owner whose name I have entered above. In consideration of the acceptance of this entry, I (we) agree to abide by the rules and regulations of The American Kennel Club in effect at the time of this event, and by any additional rules and regulations appearing in the premium list for this event, and further agree to be bound by the “Agreement” printed on the reverse side of this entry form. I (we) certify and represent that the dog entered is not a hazard to persons or other dogs. This entry is submitted for acceptance on the foregoing representation and Agreement. I (we) agree to conduct myself (ourselves) in accordance with all such Rules and Regulations (including all provisions applying to discipline) and to abide by any decisions made in accordance with them.
SIGNATURE of owner or his agent duly authorized to make this entry:
Telephone:			EMAIL ADDRESS:

AKC Rules, Regulations, Policies and Guidelines are available on the American Kennel Club Web site, www.akc.org

AGREEMENT

I (we) agree that the club holding this event has the right to refuse this entry for cause which the club shall deem sufficient. In consideration of the acceptance of this entry and of the holding of this event and of the opportunity to have the dog judged and to win prizes, ribbons, or trophies, I (we) agree to hold the AKC, the event-giving club, their members, directors, governors, officers, agents, superintendents or event secretary and the owner and/or lessor of the premises and any provider of services that are necessary to hold this event and any employees or volunteers of the aforementioned parties, and any AKC approved judge, judging at this event, harmless from any claim for loss or injury which may be alleged to have been caused directly or indirectly to any person or thing by the act of this dog while in or about the event premises or grounds or near any entrance thereto, and I (we) personally assume all responsibility and liability for any such claim; and I (we) further agree to hold the aforementioned parties harmless from any claim for loss, injury or damage to this dog.

Additionally, I (we) hereby assume the sole responsibility for and agree to indemnify, defend and save the aforementioned parties harmless from any and all loss and expense (including legal fees) by reason of the liability imposed by law upon any of the aforementioned parties for damage because of bodily injuries, including death at any time resulting therefrom, sustained by any person or persons, including myself (ourselves), or on account of damage to property, arising out of or in consequence of my (our) participation in this event, however such, injuries, death or property damage may be caused, and whether or not the same may have been caused or may be alleged to have been caused by the negligence of the aforementioned parties or any of their employees, agents, or any other persons. I (WE) AGREE THAT ANY CAUSE OF ACTION, CONTROVERSY OR CLAIM ARISING OUT OF OR RELATED TO THE ENTRY, EXHIBITION OR ATTENDANCE AT THE EVENT BETWEEN THE AKC AND THE EVENT-GIVING CLUB (UNLESS OTHERWISE STATED IN ITS PREMIUM LIST) AND MYSELF (OURSELVES) OR AS TO THE CONSTRUCTION, INTERPRETATION AND EFFECT OF THIS AGREEMENT SHALL BE SETTLED BY ARBITRATION PURSUANT TO THE APPLICABLE RULES OF THE AMERICAN ARBITRATION ASSOCIATION. HOWEVER, PRIOR TO ARBITRATION ALL APPLICABLE AKC BYLAWS, RULES, REGULATIONS AND PROCEDURES MUST FIRST BE FOLLOWED AS SET FORTH IN THE AKC CHARTER AND BYLAWS, RULES, REGULATIONS, PUBLISHED POLICIES AND GUIDELINES.

INSTRUCTIONS

Handlers may opt to enter in a higher height division for all Regular titling classes and the FAST titling classes, but not in a division lower than their proper height division.

Dogs entered in the Preferred classes must compete at the required jump height and may not compete in a jump height division higher or lower than their proper height division.

All dogs that have not been officially measured for an Agility Jump Height Card may still compete; however, they must be measured by a Judge of record, an Agility Field Representative, or a Volunteer Measuring Official, prior to running. The Judge's measurement will be valid for this trial or back-to-back trials only. If a measurement is necessary, it is the exhibitor's responsibility to have their dog(s) measured prior to running.

JUNIOR SHOWMANSHIP

If this entry is for Junior Showmanship, please give the following information:

JR.’S DATE OF BIRTH______________________ AKC JUNIOR HANDLER # _______________________

The above number MUST be included. Should you not have your Junior Handler number, this may be obtained from the American Kennel Club. Phone: (919) 816-3776.

By signing the entry form I (we) certify that the Junior Showman does not now, and will not at any time, act as an agent/handler for pay while continuing to compete in Junior Showmanship.

ADDRESS_________________________________________________________________________

CITY ____________________________________ STATE ___________ ZIP __________________

■ If Junior Handler is not the owner of the dog identified on the face of this form, what is the relationship of the Junior Handler to the Owner?

THIS FORM IS VALID FOR ALL AGILITY TRIALS HELD ON OR AFTER JANUARY 1, 2007. AEAGL2 - 01/01/07 (03/06)