ASTA TRIAL ENTRY FORM:
Pre entries close November 12th. Day of entries accepted if we have not
reached 40 runs - Limit of 40 runs Only use one form per dog
City, State, Zip:_____________________
Name Of Dog:_____________________
Please Check Level Entered: All trial levels to be run on goats.
Advanced $25.00 □ Intermediate $20.00 □ Novice $20.00 □
PAYMENT: Check ___ Cash ___ TOTAL PAID $__________
As a participant in the ASTA Stockdog Trial, I agree that in the event of personal injury, damage
to property or animals I hereby release ASTA and 4Corners, it’s members, the trial committee,
the property owner or agents and hold it harmless from all present and future loss, injury,
damage, claims and liabilities involving the entered dog, the event or the event premises. I also
understand that any questions, concerning trialing or rules will be ruled upon/decided by the trial
committee and this decision will be final. However, any problems or conflicts should be brought
immediately to the attention of the trial committee.
Exhibitor/Owner will abide by the rules of the event and the decisions of the trial committee.
Exhibitor/Owner certifies that entered dog is not a hazard to persons, dogs or other animals or
The person, owner, exhibitor signing this agreement certifies that he/she is authorized to enter
into this agreement on behalf of both exhibitor and the owner of the entered dog. In the event that
an entered dog injures stock, the owner agrees to pay all veterinary fees associated with the
general well being of that animal.
If the injury is severe or fatal, the owner will pay the market value of the stock.
Signature of Owner/Handler Date
For office use only:
Payment rec’d _____ Entries Checked _____ Entries Recorded _____ Run #__________
Mail to: Melinda Stevenson 27560 East 77 Street Broken Arrow Oklahoma 74014
(918) 557-2349 email@example.com