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									                            ENTRIES OPEN: WEDNESDAY, Sept 1, 2010 at 8:00 a.m.
                                              At 51 Duncan Road, Lagrangeville, NY 12540
                                        Entries Received Prior to OPENING DATE, will not be accepted

                                ENTRIES CLOSE: FRIDAY, Nov. 19, 2010 at 6:00 p.m.
                                               Method of Entry is First Received
                          Envelopes/transactions cannot have entries for more than the (10) dogs maximum. (

                             Premium List for Event #s: Sat 2010528803; Sun 2010528804__

                                       Skyline Agility Club
                                        Novice Only Trial

                                  AKC LICENSED ALL-BREED AGILITY TRIAL
                                SAT – SUN, December 4, 5 2010
                                                       Skyline Training Building
                                                    Garnerville Holding Company
                                                   55 Railroad Avenue - Building #1
                                                            Garnerville, NY

                                    ENTRIES ARE LIMITED TO                  330 RUNS PER DAY
                                                Show Hours: 7:00 a.m. to ½ hour after last run.
Lagrangeville, NY 12540

                                   Trial will be held indoors on mats, rain or shine - Ring Size 65’ x 110"
Lavonda L. Herring
51 Duncan Road

                                        Permission has been granted by the American Kennel Club for the holding of this event
                                                 under AKC Rules and Regulations. James P. Crowley, Secretary.
                          OFFICERS OF SKYLINE AGILITY CLUB                                                                                            SITE INFORMATION

President ......................................................................................... Iraida Jimenez                 Building is a 2 story walk up. It is heated but tends to be chilly,
Vice President ................................................................................... Lori Wolbach                    dressing in layers is suggested.
Treasurer............................................................................................ Amy Koebler
                                                                                                                              Please park as directed by the trial officials. To assist with parking
Secretary ........... Kristen Mathieson, 581 Green Valley Road, Paramus, NJ 07652
                                                                                                                                   please car pool if possible.
                                                                                                                              There is a designated “potty” area. Please clean up after your dog
                                           BOARD MEMBERS                                                                           and place waste in the receptacles provided by the club. Do not use
                                                                                                                                   any dumpster or allow dogs to urinate on buildings.
                Helen Sherman, Betsi Hartman, Rae Jeffs, Barbara Kennedy                                                      Crating space is extremely limited. Unentered dogs are not
                                                                                                                                   allowed in the building. Our parking lot is a safe area. No ex-pens.
                                              Trial Committee
                                                                                                                              Bring a folding crate, treats, poop bags and water bowl for your dog.
              Lavonda Herring, Gail Banta, Betsi Hartman, Lynn Pettipaw,                                                     Snacks or beverages will not be available for sale, there are several
              Rae Jeffs, Sue Doelling and all members of Skyline Agility Club                                                      food vendors within a minutes drive.
                                                                                                                       A light breakfast and lunch will be provided for workers.
Trial Chairperson ….Gail Banta… 21 Fairview Ave., Park Ridge NJ 07656 201-573-1020
Asst. Chairperson…Sue Doelling……..………....32 MacArthur Ave., Closter, NJ 07624
Secretary …..............Lavonda L. Herring……………………… Phone 845-724-5686                                                         VERY IMPORTANT - Parking and Pooping Rules
………………….51 Duncan Road, Lagrangeville, NY 12540 LLHWOOF @AOL .com
                                                                                                                                Park in the parking lot only. As you enter the gates there is a small
                        JUDGE – All Novice Classes for Both Days                                                      parking area - under no circumstances are you permitted to park there -
                                                                                                                      continue around to your right and there are some additional spaces (you may park in
Arleen Spooner# 90109 - 692 Cooper Drive, Oradell, NJ 07649                                                           those, but it is not preferred). You should park toward the green sheds and the
Classes Offered: All Regular and Preferred Standard Novice Classes                                                    building which has the brick chimney.
                 All Regular and Preferred JWW Novice Classes                                                         The grassy area above the parking lot (behind the long red brick building) is our
                 All Regular and Preferred FAST Novice Classes                                                        designated potty area. Your dog is allowed to relieve himself only in that area. Dogs
Note: A, B, & P classes will run together.                                                                            must not be allowed to urinate on stock or pallets in the roadway areas. All
                                                                                                                      droppings (your dog or someone else's) must be picked up. We are a "carry in carry
                                 VETERINARIAN (On Call)                                                               out" facility. Do not use dumpsters in the complex - they do not belong do us.

                           Valley Cottage Animal Hospital                                                                             About Emailed Correspondence
              202 Route 303 Valley Cottage, NY 10989 845-268-9263
From Skyline parking turn right onto Railroad Avenue for 0.3mile. Turn right onto                                    Emails sent to me regarding cancellations, etc will be addressed on a priority basis.
US-9W for 4.2 miles. Stay straight onto N RT-303 for 2.9 miles. Valley Cottage is                                    All correspondence will be processed within one week of receipt.
on the left.
                                                                                                                     I always send a reply email to all emailed cancellation requests when they are
                                              OBSTACLES                                                              If a response is NOT received before the above deadlines, please call the trial
                                                                                                                     secretary. Cancellation and changes to class deadline is trial closing date.
 Obstacles will meet the specifications for obstacles in the current edition of the                                  Please remember that Skyline Club is not responsible for emails that do not get
Regulations for Agility. There is no electronic timing at this event. All classes will                               delivered and therefore will not cancel an entry after the closing date and time due to
Take place under cover, on a matted surface. Ring size will be 65 x 110                                              non delivery of an email request.
                                                                                                           with your back to the main gate. The road passes between two warehouses. Walk
                                                                                                           down this road, Skyline is the second building on the right and we are upstairs.
                                            MOTELS                                                         From The Southbound Palisades Parkway:
                           MOTEL COURTESIES TO OBSERVE                                                     Take PIP south to exit 13, turn left onto Rte 202 East and proceed as above.
We are counting on you to be on your best behavior in order to maintain the working
relationship with our motels and campgrounds. Our hard-earned reputation, as well as our                   For Commercial Vehicles:
ability to continue hosting trials, is certainly on the line and dependent on YOUR cooperation.            Take route 9W north towards Haverstraw. You will cross Rte. 202 and
We follow up on any complaints from motel owners or guests, so please report any issues to                 continue on 9W past all the fast food outlets. After passing KFC on the right,
us.                                                                                                        turn left at the next light onto Railroad Ave. At the top of the hill, turn left into
                                                                                                           Garnerville Industrial Center and proceed as above.
. Double-check on rates & charges. Call to confirm your reservation a few days before arriving.
. Be sure your dog is free of fleas BEFORE arriving.
. Please be honest about how many people & dogs will be staying in the room.                                                                           RV INFORMATION
. Of course, as is standard agility procedure, all handlers/owners will pick up after their dogs. Please
  bag and dispose of dog waste properly.
                                                                                                           There is no RV parking at Skyline Agility Club.
. Please cover the motel's bedding with a sheet or blanket from home, whether or not you think your dog
   will get on the bed.
Don't EVER leave dogs unattended. Take them with you when you go out for dinner. Even the best of
dogs can get carried away in a motel room without you present.                                             FIRST PLACE ..................................................................................................Blue Rosette
                                                                                                           SECOND PLACE.............................................................................................. Red Rosette
The following will accept well-mannered dogs. (However, exhibitors should double check when making
                                                                                                           THIRD PLACE .............................................................................................. Yellow Rosette
reservations in as much as motels sometimes change their policies).                                        FOURTH PLACE ........................................................................................... White Rosette
Days Inn 367 Route 59, Nanuet, NY 10954-2908, (845)623-4567                                                QUALIFYING ........................................................................................ Dark Green Ribbon
Approx. $98/night, $20 pet fee, Better Rate w/ AAA disc. 20 minutes from site
                                                                                                           Please see the AKC Regulations for Agility Trials for current class descriptions.
Nyack Motor Lodge 110 N Route 303; West Nyack, NY 10994-2034 (845)358 4100                                 Dogs must be entered only in Regular Classes or Preferred Classes with no
Approx. $75, 15 min. from site                                                                             crossover between them allowed at the same set of trials.
Econolodge 17 Main Street, Highland Falls, NY 10928 (845)446-9400 Approx.
$95/night + $10 pet fee

Candlewood Suites, Nanuet $71 per nite 20 Minutes – 12 miles..                                                                                        HEIGHT DIVISIONS
La Quinta Inn 540 Saw Mill River Road, Elmsford, NY 10523 (914)592 3300 Approx.
$99, 29 minutes – 20 miles.
                                                                                                           Owners/Agents are responsible for entering the proper height divisions. All height divisions will
Highland Falls Best Western, Highland Falls, NY 845-446-9400 $95 + pet fee.                                be offered in both the standard classes and the jumpers with weaves classes.
                                                                                                           Regular Exhibitors may choose to enter their dog in a higher height division than required by
Approx 25 minutes from site
                                                                                                           AKC, but not in a height division lower than the AKC mandated height
                                                                                                           Preferred The following jump heights must be used in all Preferred Classes.
                                         ROUTE TO SHOW                                                                                                        REGULAR                                   PREFERRED
                                                                                                           Dogs 11 inches and under at the withers              8 inches                                 4 inches
NOTE—Commercial vehicles/Trailers are not permitted on the Palisades.                                      Dogs 14 inches and under at the withers              12 inches                                8 inches
                                                                                                           Dogs 18 inches and under at the withers              16 inches                                12 inches
From The Northbound Palisades Parkway:
                                                                                                           Dogs 22 inches and under at the withers              20 inches                                16 inches
Take PIP north to exit 13. At the end of the ramp, bear right. At the first light, turn                    Dogs over 22 inches                                  24 inches                                20 inches
left onto Rte 202 East for approx. 2 miles. You will eventually pass a big ShopRite                        Dogs may be entered at 26” height at their owner’s discretion.
on your left, then the road goes downhill to a traffic light- at this light, turn left onto
Main St. At the next light, turn right onto Railroad Ave. Continue straight thru the
flashing light and pass a long white warehouse on the right – at the far end of the
warehouse, turn right into the Garnerville Industrial Center. After parking, stand
                          ENTRY FEES PER DAY                                                               MEASURING AND HEIGHT CARDS
          MAKE ALL CHECKS & MONEY ORDERS payable to
                                                                                          When filling out the entry form, there is a section at the top of the form for
                    Skyline Agility Club                                                  exhibitors to designate whether your dog has a valid jump height card or if
                                                                                          your dog needs to be measured. Please check the appropriate box so that
                                                                                          the Trial Secretary knows whether to include your dog on the Dogs To Be
                                                                                          Measured List. It is no longer required that you submit a copy of your dog’s
OPENING DATE FRI., 8:00 a.m. September 1, 2010 at 51 Duncan Road,                         jump height card with your entry form or show it during the day of show
 Lagrangeville, NY 12540 Trial is LIMITED to 330 runs per day.                            check-in.
CLOSING DATE for entries Fri., 6:00 p.m., Nov. 19, 2009, after which entries
                                                                                          How do I know if I have a valid jump height card?
  cannot be accepted, cancelled or substituted except as provided for in Chapter
  11, Section 6 of the Dog Show Rules and in Chapter 1, Section 13 of the AKC             If your dog is under the age of two years as of the trial’s date: One (1)
  Agility Trial Rules and Regulations.                                                    temporary measurement is required. Once measured, be sure to retain the
                                                                                          Agility Measurement Form yellow copy and check “My dog has a
MAIL ALL ENTRIES to SKYLINE, c/o Lavonda L. Herring, 51 Duncan Road,                      *Temporary* Jump Height Form” box, otherwise your dog needs to be
  Lagrangeville, NY 12540                                                                 measured. If your dog turns two years of age or is older as of the trial’s date,
Express mail entries must include the signature waiver allowing them to be left at                                                  nd
                                                                                          your temporary card expires on their 2 birthday and your dog needs to be
  the secretaries address.
REFUNDS: There shall be no refunds for entries withdrawn in the event a dog               If your dog is over two years of age as of the trial date: A minimum of two (2)
  and/or handler are injured, absent, or dismissed from competition,                      permanent measurements are required by a VMO. Until you get both of
  regardless of the reason for such dismissal. If because of riots, civil                 those measurements you will continue to check “my dog needs to be
  disturbances or other acts beyond the control of management it is impossible to         measured” box.
  open or complete the show, no refund of entry fee will be made. Refunds are             If there is no VMO at the trial, you will be measured by the judge for that
  allowed if requested before the closing date. Refunds after closing date for            weekend only. If your dog jumps 24” and there is no VMO present, you do
  bitches in season only. A $10.00 processing fee for ANY refunds. No refunds
  for overpayments of less than $10.
                                                                                          not need to be measured for that weekend. If there is a VMO present you
BITCHES IN SEASON are not eligible to participate. Entry fees will be refunded            must be measured.
subject to a $10.00 processing fee.
Requests for bitch in season refunds MUST BE RECEIVED within 48 hrs of
start of trial – Thursday at 8am. The request for refund must be verified by a
veterinarian certificate. After the closing date, Skyline will only process                                           NOVICE MOVE-UPS:
refunds for bitches in season.
                                                                                          NOVICE MOVE UPS: Dogs or Handlers having attained ANY AKC
Returned Checks: I will not return checks for entries that are not accepted or            Agility Title (Std, JWW, OR FAST class) must be moved to the Nov B
entries cancelled before the check has been deposited. I shred all unused
                                                                                          Classes (Std, JWW and FAST classes) for all trials that have reached the
                                                                                          final closing date at the time that they get that first title.
                                                                                           So be sure and contact the trial secretary to change your entry from Novice
                                                                                          A to Novice B
I will send preliminary confirmations either as attachments via email or in the body of   Once a trial closing date has past, a dog cannot be moved from Nov A to
an email to all exhibitors who provide their email address. If you do not have an         Nov B.
email address and want a preliminary confirmation, please send a stamped self-             If the trial has already reached the closing date on the day the dog obtained
addressed envelope.                                                                       its title, the dog shall remain in the class in which it was originally entered.

            TRIAL REGULATIONS NOTICE TO EXHIBITORS                                                             Skyline Agility Club
THE TRIAL will be open from 7:00 a.m. to ½ hour after last dog runs.
                                                                                                             WOULD LIKE YOU TO HELP
RETURNED CHECKS do not constitute a valid entry fee. A charge of $25.00 will be made
    for each returned check.                                                                    We could use your help! Consider volunteering to work at the trial. If you
                                                                                                can, please fill out the volunteer form below and return it with your entry.
    FORMS without the Agreement and Rules attached to the Official AKC Entry Form are                 Snacks and beverages will be provided to all who work.
    NOT ACCEPTABLE.                                                                                                   If you decide later, please mail to
NO ENTRY SHALL BE MADE AND NO ENTRY SHALL BE ACCEPTED, WHICH                                                                   Rae Jeffs
    SPECIFIES ANY CONDITIONS AS TO ITS ACCEPTANCE.                                                                39 Jones Dr, Garnerville, NY 10923
                                                                                                            Phone: 845-947-8300 Email:
ACKNOWLEDGEMENT OF ENTRIES will be made as soon as trial closes or limits are
   reached. Acknowledgment of entries will include confirmation notices.

ENTRY FEES shall not be refunded in the event that a dog is absent, disqualified, excused      1. I will work on:            ____Sat              ____Sun
   by Veterinarian or Judge, or barred from competition by action of Trial Committee. If
   because of riots, civil disturbances or other acts beyond the control of the                Name: ______________________________________________________
   management, it is impossible to open or to complete the match, no refund of entry fees
   will be made.                                                                               Phone: _____________ Email: __ _______________________________

ERRORS ON ENTRY BLANKS-Owners are responsible for errors in making out entry                   I am running ____dogs         Other Notes regarding my availability:
   forms, and no entry fee will be refunded in event of such errors or cancellation of
   entries after trial has closed.                                                             _____________________________________________________________
CONSULT FINAL CONFIRMATION FOR TIME OF JUDGING.                                                _____________________________________________________________
JUDGES ARE NOT REQUIRED TO WAIT FOR DOGS. The Owner of each dog is solely
   responsible for having it ready at ringside when it is to be judged. The Club has no        2. Enter CALL NAME, JUMP HEIGHT, CLASSES, &
   responsibility for providing service through a public address system or stewards or
   runners for the purpose of calling or locating dogs that are not brought into the ring      Days Entered for each dog.
   when required.                                                                                CALL NAME       J     STD   Sat   Sun   JWW    Sat   Sun    Fast   Sat   Sun
TRIAL COMMITTEE will use due care and diligence for the welfare of dogs and exhibitors,
    but will not be responsible for, nor assume any liability in the event of an accident or
    misfortune to either dogs or exhibitors participating in this show.

DOGS PARTICIPATING must be fifteen months of age or older and must be registered with
    the American Kennel Club or are registerable breeds that have obtained an AKC ,ILP or
    PAL number (effective Feb. 1, 2009). Dogs must be physically sound. Dogs that are          3. Check the jobs you are willing to help with.
    blind or deaf shall not be eligible. No dog shall compete if it is taped or bandaged in
    any way or has anything attached to it for medical purposes. Dogs under 6 months of
    age are not permitted on show grounds.                                                     __ Gate Steward          __ Scribe Asst.         __ Course Builder
  Mixed breed dogs that have been listed with AKC Canine Partners may participate              __ Scribe                __ Score Runner         __ Leash runner
    provided their listing number has been recorded on the entry form. Refer to Chaper 2
    of the Registration and Discipline Rules for the listing of registerable breeds that may
                                                                                               __ Timer                 __ Ring Crew            __ Sunday Clean Up
    participate.                                                                               __ Friday Setup
DOGS MAY ARRIVE any time prior to Judging. If they need to be measured they must be
   available for measuring before their class begins.                                          4. Please enclose this form with your entry.
          Exhibitors should follow their veterinarians’ recommendation to                                              Thank You for Volunteering
           assure their dogs are free of internal and external parasites, any
             communicable diseases, and have appropriate vaccinations.
                      OFFICIAL AMERICAN KENNEL CLUB ENTRY FORM FOR AGILITY                                                                     AKC Rules, Regulations, Policies and Guidelines are available on the American Kennel Club Web site,

                            SKYLINE AGILITY CLUB                                                                                                                                           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
 Sat 12/4 [ ] STD               [ ] JWW [ ] FAST 1 only $24                        2 classes $36        All 3 classes $48   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
 Sun 12/5 [ ] STD               [ ] JWW [ ] FAST 1 only $24                        2 classes $36        All 3 classes $48
                                                                                                                            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
    Make All Checks Payable to Skyline Agility Club                                                                         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
                Entry Fees: $24 for first class each day/$12 for additional class each day                                  about the event premises or grounds or near any entrance thereto, and I (we) personally assume all responsibility and
                                        (Includes $3.00 AKC recording fee per run)                                          liability for any such claim; and I (we) further agree to hold the aforementioned parties harmless from any claim for loss,
      Trial is limited to 330 runs/day Trial Opens Wed 9/1/09 8 am -- Trial Closes Fri 11/19/09 6 pm                        injury or damage to this dog.
Mail to: SKYLINE, Lavonda L. Herring 51 Duncan Road, Lagrangeville, NY 12540                                                Additionally, I (we) hereby assume the sole responsibility for and agree to indemnify, defend and save the aforementioned
                  (IMPORTANT: CAREFULLY READ INSTRUCTIONS ON REVERSE SIDE BEFORE FILLING OUT)                               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,
 BREED                            SEX          [ ] MY DOG NEEDS TO BE MEASURED                                    HT at
                                                                                                                            sustained by any person or persons, including myself (ourselves), or on account of damage to property, arising out of or in
                                               [ ] MY DOG HAS A TEMPORARY JUMP HT FORM                                      consequence of my (our) participation in this event, however such, injuries, death or property damage may be caused, and
                                               [ ] MY DOG HAS A PERMANENT JUMP HT CARD                                      whether or not the same may have been caused or may be alleged to have been caused by the negligence of the
 Regular Standard Class (Circle one)       Regular Jumpers w/Weaves (Circle one)            Regular FAST (Circle one)       aforementioned parties or any of their employees, agents, or any other persons. I (WE) AGREE THAT ANY CAUSE OF
 Nov A Nov B Open Ex A Ex B                Nov A Nov B Open Ex A Ex B                Nov A Nov B Open Ex A Ex B             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
 JUMP HEIGHT (Circle One)              8” 12” 16” 20 ” 24”” 26”                                                             IN ITS PREMIUM LIST) AND MYSELF (OURSELVES) OR AS TO THE CONSTRUCTION, INTERPRETATION AND
   Preferred Standard Class (Circle         Preferred Jumpers w/Weaves (Circle             Preferred FAST (Circle one)      EFFECT OF THIS AGREEMENT SHALL BE SETTLED BY ARBITRATION PURSUANT TO THE APPLICABLE RULES
                 one)                                      one)                                                             OF THE AMERICAN ARBITRATION ASSOCIATION. HOWEVER, PRIOR TO ARBITRATION ALL APPLICABLE AKC
                                                                                     Nov P Open P Ex AP Ex BP
 Nov P Open P Ex AP Ex BP                  Nov P Open P Ex AP Ex BP                                                         BYLAWS, RULES, REGULATIONS AND PROCEDURES MUST FIRST BE FOLLOWED AS SET FORTH IN THE AKC
                                                                                                                            CHARTER AND BYLAWS, RULES, REGULATIONS, PUBLISHED POLICIES AND GUIDELINES.
                               JUMP HEIGHT (Circle One)             4” 8” 12” 16” 20”
                         (CIRCLE CLASS )     STD     JWW                                           14” 18” 26”              Handlers may opt to enter in a higher height division for all Regular titling classes, but not in a division lower than
 AKC® NAME (Include AKC titles only)                                                            CALL NAME                   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. If
                                            (Enter Number Below)     DATE OF BIRTH                                          measured by the Judge of record, that measurement will be valid for this trial or back-to-back trials only. If a measurement
 [ ] AKC® NO.                                                                                                               is necessary, it is the exhibitor's responsibility to have their dog(s) measured prior to running.
                                                                     PLACE OF BIRTH (list country)                          Mixed breed classes may only be offered at standalone all-breed AKC agility trials. A standalone agility event is defined as
  [ ] ILP. [ ] PAL [ ] FOREIGN REG NO. & COUNTRY                                                                            an agility trial that is not held on the same date and show site as an AKC All-Breed Dog Show or Independent Specialty for
 Breeder                                                                                                                    conformation. Dogs entered in the mixed breed classes must list the breed name as “mixed breed” and not as a breed
 Sire                                                                                                                       Junior Handlers should enter their Junior Handler number on the front of this form. Should you not have your Junior
                                                                                                                            Handler it may be obtained from the American Kennel Club (919) 816-3776. If the 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?
                                                                                                                             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 ha
                                                             e                                                              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 above on 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
 CITY, STATE & ZIP + 4                                                                                                      Regulations (including all provisions applying to discipline) and to abide by any decisions made in accord with them.
                                                                                                                            SIGNATURE OF OWNER OR HIS AGENT DULYUTHORIZED TO MAKE THIS ENTRY
 HANDLER (if junior handler please enter # below)                                           FEE ENCLOSED                    TELEPHONE :
                                                                                                                            E-MAIL ADDRESS:

                 *Clubs are eligible to offer mixed breed classes at agility trials beginning April 1, 2010.

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