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AMERICAN BELGIAN MALINOIS AMERICAN BELGIAN MALINOIS Club.pdf

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					                               Premium List (revised 11/9/2010)
        Event #s- Friday (#2011418201), Saturday (#2011418202), Sunday (#2011418203)


AMERICAN BELGIAN MALINOIS Club
                            AKC All-Breed Agility Trial
                              (Member of the American Kennel Club)

              Open to Dogs Listed in the AKC Canine Partners Program.




       Friday, January 14th, Saturday, January 15th &
                  Sunday, January 16th, 2011
                 Standard and Jumpers with Weaves Classes offered
                           All Levels – All Three Days

                                        Simon Arena
                                     29100 Harry Avenue
                                     Randolph MN 55065

                         Entries Limited to 660 runs each day.

                     Method of Entry—First Received
        Entries open Wednesday, December 1st, 2010 at 8:00am.
                     Any entries received before this date will be returned.
             No Hand Delivered entries accepted before Thurs, Dec 2nd at 8:00am.
       Any envelope, mailed or hand delivered, containing more than the ten dog maximum
                       constitutes an invalid entry and will be returned.
           All express mail must be left with no acceptance signature required.

        Entries close Wednesday, December 29th, 2010 at 5:00pm
After which time entries cannot be accepted, canceled, altered, or substituted except as provided for
                         in Chapter 11, Section 6 of the Dog Show Rules.


           Show hours: 6:00am-6:00pm each day. Building opens at 6:00am each day.

                             AMERICAN KENNEL CLUB CERTIFICATION
                             Permission has been granted by the American Kennel Club for the
                             holding of this event under American Kennel Club Rules & Regulations.
                             James Crowley, Secretary.
                                                                                                                            VOLUNTEER WORKER SIGN-UP
 Mail all entries with fees (check or money order) payable to Bluestem ATS to:                                American Belgian Malinois Club -- January 14, 15 & 16, 2011
                Lorah Marquardt, Bluestem Agility Trial Services
                                1124 W. River Drive                                                  We all know that trials cannot run smoothly without the help of volunteers.
                              Stevens Point, WI 54481                                                                    Please be generous with your time.
                          Questions Call: (715) 342-0679
                    Or Email (preferred): bluestemK9@att.net
                       Website: www.BluestemAgility.com                                                Name:

           All express mail must be left with no acceptance signature required                      EMAIL:

                                                                                                   Address:
         Entry fee of $23.00 for the first entry of each dog per day                               (if no email)
                      (includes $3.00 AKC recording fee);
        $12.00 for the second entry of the same dog on the same day                                    Phone:
                         (includes $3.00 AKC recording fee).
                                                                                                Check classes entered and write in jump height divisions:
                                                  th
Entries close 5:00pm, Wednesday, December 29 , 2010. Entry changes, additions,
corrections and cancellations MUST be received in writing or via email prior to the closing                                          Friday               Saturday               Sunday
date, and include the AKC registration number and registered name of dog, or no refunds                                      Class     Height         Class     Height   Class     Height
will be issued. No verbal changes accepted.
                                                                                                     STD           Exc
                                                                                                                   Open
     AMERICAN BELGIAN MALINOIS CLUB OFFICERS                                                                       Novice
                                                                                                     JWW           Exc
   President: Suzanne Belger                Treasurer: Angela Silvestri
   First Vice President: Jane Rothert       Recording Secretary: Polly Fabrizio
                                                                                                                   Open
   Second Vice President: April Albert      Corresponding Secretary:                                               Novice
   Director: Jo Ann Charnik                  Allison Gil, 728 Blackbird Landing Rd
   Director: Catherine Shields               Townsend DE 19734                                  Check jobs you would be willing to work:

                            EVENT COMMITTEE                                                          Job:                     Fri      Sat      Sun    Job:              Fri     Sat   Sun

     Event Co-Chairs: Judy Hagen, 2526 62nd St E, Inver Grove Heights MN 55407                       Course Builder                                    Gate Steward
              Kathy Eckert, 7616 64th Ave N, Brooklyn Park MN 55428                                  Timer                    XX       XX       XX     Ring Crew
     Members: Linda Friedow, Rory Friedow, Val Hinz, Ann MacKay, Janet Sinner,
                                 Wendy Sommer                                                        Scribe                   XX       XX       XX     Leash Runner
                                                                                                                                                       Scribe Sheet
                                                                                                     Transcribe                                        Runner
           Volunteer Coordinator: Becky Eckert, ecker067@umn.edu
                                                                                                Please note any additional information:
                                 TRIAL JUDGES:
             Alan Arthur (#65781), 1361 Woods Dr, Keller TX 76262
       Classes: Friday: Standard; Saturday: Jumpers; Sunday: Standard

                                                                                              Thanks for volunteering—Your help is greatly appreciated! Contact volunteer coordinator Becky
            Jill Roberts (#53211), PO Box 650417, Vero Beach FL 32965                         Eckert at ecker067@umn.edu with any questions.
        Classes: Friday: Jumpers; Saturday: Standard; Sunday: Jumpers
                         AKC AGILITY MOVE-UP FORM                                                  RUNNING ORDER and START TIMES:

  MOVE-UP REGULATIONS:                                                                                 Friday                          Saturday                         Sunday
  If a dog earns an AKC agility title before this event, it can be advanced to the next               7:00 AM Check-in                7:00 AM Check-in                 7:00 AM Check-in
  level of competition. However, written notice must be given to the Trial Secretary no               8:00 AM Judging begins          8:00 AM Judging begins           8:00 AM Judging begins
  later than 6pm on Monday, Jan 10th, 2011. Day to day move-ups will be accepted
  if received before the close of the trial Friday, Jan 14th, or Saturday, Jan 15th,
  2011. Trial close will be considered to be the awarding of ribbons for the last class                STANDARD:                       STANDARD:                       STANDARD:
                                                                                                       Novice; Open; Excellent         Novice; Open; Excellent         Novice; Open; Excellent
  on that day. Move-ups will be added to the end of the running order of the class they
  move up to and every effort will be made to accommodate handlers running multiple                    JUMPERS W/ WEAVES:              JUMPERS W/ WEAVES:              JUMPERS W/ WEAVES:
  dogs in the same class.                                                                              Excellent; Open; Novice         Excellent; Open; Novice         Excellent; Open; Novice

  Move-up form must be submitted—Verbal requests will not be accepted. Fill out                        Small to Tall Dogs              Tall to Small Dogs              Small to Tall Dogs
  each change and send to the Trial Secretary’s home address. E-mailed requests
  accepted as long as all information is included.                                                 SITE INFORMATION:
                                                                                                   All classes will be held indoors on packed dirt. Ring sizes are 92ft. x 101ft and. 92ft. x
------------------------------------------------------------------------------------------------   105ft. Exhibitors and spectators are expected to keep the entire area clean. Anyone
                                                                                                   witnessed not picking up after their dogs on the trial grounds will be excused from the trial
                                                                                                   with no entry fees refunded. Note: Building temp held around 50-60 degrees, please
  AKC Registered Name: _________________________________________                                   dress accordingly.

                                                                                                   CRATING:
  AKC Registration #: ___________________________________________                                  No crates may be set up before 6:00 am on Friday, January 14th, 2011. Crates may be left
                                                                                                   overnight, however, ABMC, Simon Arena and Bluestem Agility Trial Services, LLC will not
                                                                                                   be responsible for any lost or damaged items left at the show site. Dogs may not be left
                                                                                                   overnight.
  Breed: ____________________________ Call name: _________________
                                                                                                   FOOD:
                                                                                                   Food and beverages will be available at the show site
  Owner(s): ____________________________________________________
                                                                                                   CATALOGS:
  Please circle:                                                                                   Running order sheets will be available to all exhibitors at no charge. Full catalogs will
  Days entered:            Friday          Saturday             Sunday                             be available for sale for $8.00 on the day of the trial, but supplies will be limited. Advanced
                                                                                                   catalog sales recommended. Please indicate on your entry form if you would like a catalog.
  Height Division:           4”         8”         12”        16”       20”        24”
                                                                                                   PRIZES AND AWARDS:
                                                                                                   Ribbons will be awarded to First through Fourth place in each class and height division.
      Class:              Standard                    Preferred Standard                           Qualifying ribbons will be awarded to those dogs receiving qualifying scores. New title
                                                                                                   ribbons, Double Q ribbons, and MACH rosettes will also be awarded. Dogs must qualify to
   Entered in:              Novice                 Open                   Exc A                    receive placement ribbons. Prizes must be claimed the day of the show-none will be mailed.
   Move to:                 Open                   Exc A                  Exc B


                                                                                                                                 VETERINARIAN ON CALL:
      Class:                JWW                          Preferred JWW
                                                                                                                                  Michael R Pedersen DVM
   Entered in:              Novice                 Open                   Exc A                                                       1415 N Hwy 20
   Move to:                 Open                   Exc A                  Exc B                                                    Cannon Falls MN 55009
                                                                                                                                       507-263-3929
                                                                                                                                                  .
                                                                                                                 HOTEL INFORMATION:
JUMP HEIGHT DIVISIONS:                                                                                           The following area hotels accept well-behaved people and their pets. Exhibitors must contact hotels
Owners are responsible for entering the proper height division.                                                  directly and identify themselves as having dogs. Some of these hotels do charge an extra fee for
Height at Withers         Jump Height Regular Classes           Jump Height Preferred Classes                    dogs. Be sure to verify the dog policy with the hotel of your choice when you make your
11” and under                         8 inches                           4 inches                                reservation. Please be a responsible owner and a considerate hotel guest by maintaining a restful
14” and under                         12 inches                          8 inches                                atmosphere and cleaning up after your dog.
18” and under                         16 inches                          12 inches
22” and under                         20 inches                          16 inches                               Best Western Rivertown Inn & Suites,
Over 22”                              24 inches                          20 inches                                   752 Withers Harbor Dr, Red Wing MN 55066                                 651-388-1577
26 inch jump height may be entered at the owner’s discretion.
                                                                                                                      Pets allowed in downstairs smoking rooms only. $15 charge per dog per night.
HEIGHT CARD REQUIREMENT:                                                                                         Best Western Saratoga Inn,
When filling out the entry form, please designate whether your dog has a valid jump height card or if your           31591 64th Ave, Cannon Falls MN 55009                                    507-263-7272
dog needs to be measured so that the Trial Secretary knows whether to include your dog on the Dogs To                 Pets under 15 lbs, smoking rooms only, $15 charge for length of stay.
Be Measured List. It is the sole responsibility of the exhibitor to have their original, official jump height    Caravan Motel,
card or temporary jump height form at each trial to present upon request. Additionally, if a measurement is
necessary, it is the exhibitor’s responsibility to have their dog measured prior to running. Regulations for         31913 64th Ave, Cannon Falls MN 55009                                    507-263-4777
Agility Trials, Chapter 2, Section 4.                                                                                 $10 per night fee for non-smoking rooms, no pet fee for smoking rooms
                                                                                                                 Country Inn 7 Suites Hastings,
REFUNDS:                                                                                                            300 33rd St, Hastings MN 55033                                            651-437-8870
No entry fees will be refunded if the trial cannot open or be completed by reason of riots, civil
                                                                                                                      Standard, smoking rooms, $10 charge for length of stay.
disturbances, fire, act of God, public emergency, act of a public enemy, or any other cause beyond
the control of the organizing committee. Entry fees shall not be refunded in the event that a dog is             Microtel Inn & Suites Inver Grove Heights,
absent, disqualified, excused by a judge, or barred from competition by action of the Event                          5681 Bishops, Inver Grove Heights                                        651-552-0555
Committee. Entry fee for bitches that come into season or a dog that is injured after the closing date                $25 per dog per night.
will be refunded (less $12 administrative fee per day) if Trial Secretary is notified 30 mins before the         Super 8 Northfield,
start of judging that day.
                                                                                                                     1420 Riverview Dr, Hwy 3 S, Northfield MN 55057                          507-663-0371
OBSTACLES & TIMERS:                                                                                                   $10 per dog per night.
Obstacles will meet the specifications in the current edition of the Regulations for Agility Trials. 24”         Super 8 Red Wing,
weave poles will be used. Electronic timing will be used.                                                            232 Withers Harbor Drive, Red Wing MN 55066                              651-388-0491
                                                                                                                      Please check with hotel for pet policy.
DOGS ELIGIBLE TO ENTER:
This trial is open to all dogs 15 months of age or older that are registered with the American Kennel Club,
or are registerable breeds that have obtained an AKC, ILP or PAL number. Bitches in season, aggressive,
blind or deaf dogs or dogs suffering from any deformity, injury or illness which may affect the dog’s            DIRECTIONS TO
physical or mental performance are ineligible to participate. Mixed breed dogs that have been listed with        TRIAL SITE:
AKC Canine Partners may participate provided their listing number has been recorded on the entry form
and the trial-giving club is offering the optional mixed breed classes.                                              Simon Arena,
                                                                                                                     29100 Harry Ave,
RINGSIDE:                                                                                                            Randolph MN 55065
Dogs are not required to be at the trial until the scheduled time of judging. All dogs not needed for further
judging are excused. The owner or handler of each dog is solely responsible for having the dog ready at          From the North: Take
ringside when the class is to be judged. Please help your fellow competitors, the trial workers, and the         US Hwy 52 south from I-
judge by checking in with the gate steward well ahead of your turn, and being prompt at the line when
your turn comes to run.
                                                                                                                 494 approximately 25
                                                                                                                 miles to County Rd 86.
SAFETY AND BEHAVIOR:                                                                                             West to Harry Ave
The safety of the dogs is our primary concern. By entering this trial, exhibitors acknowledge that they are      (frontage road on west side of
familiar with the rules and regulation of this sport and that their dogs are familiar with and able to perform   Hwy 52). South on Harry
all obstacles safely. Exhibitors should follow their veterinarians’ recommendation to assure their dogs are
free of internal and external parasites, any communicable diseases, and have appropriate vaccinations.
                                                                                                                 Ave 1 mile.

LIABILITY:                                                                                                       From the South: Take
It is expressly understood that exhibitors alone are responsible for the behavior of their dogs and/or           US Hwy 52 north from
children. Any exhibitor whose dogs and/or children create unnecessary disturbances or repeatedly engage          Cannon Falls to County Rd
in unsafe or disruptive behavior may, at the discretion of the Trial Committee, be asked to leave the show
site. In such cases, no refund of any fees paid will be made. ABMC, Simon Arena, nor Bluestem Agility
                                                                                                                 86. West to Harry Ave
Trial Services, LLC will assume no responsibility for any loss, damage or injury sustained by exhibitors or      (frontage road on west side of
handlers, or to any of their dogs or property, and further assumes no responsibility for injury to children.     Hwy 52). South on Harry
                                                                                                                 Ave 1 mile.
                                                                                                                                       AKC Rules, Regulations, Policies and Guidelines are available on the American Kennel Club Web site, www.akc.org
                                             OFFICIAL ENTRY FORM FOR AGILITY TRIALS

                                              AMERICAN BELGIAN MALINOIS 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
                                                           January 14, 15 & 16, 2011                                                   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,
                       STD Classes:              Friday            Saturday             Sunday              All three days             governors, officers, agents, superintendents or event secretary and the owner and/or lessor of the premises and any provider
                       JWW Classes:              Friday            Saturday             Sunday              All three days             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
       Entry fees: $23 for first entry (inc $3 AKC recording fee), $12 for second, same dog, same day (inc $3 AKC recording fee).      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
          I would like a Trial Catalog ($8 pre-paid)          Mail all entries with fees (check or money order) payable to             near any entrance thereto, and I (we) personally assume all responsibility and liability for any such claim; and I (we) further
               Bluestem ATS to Lorah Marquardt, Trial Secretary, 1124 W River Dr, Stevens Point WI 54481                               agree to hold the aforementioned parties harmless from any claim for loss, injury or damage to this dog.
(IMPORTANT: CAREFULLY READ INSTRUCTIONS ON REVERSE SIDE BEFORE FILLING OUT)
BREED                                                                   VARIETY
                                                                                                                                       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
SEX                       [ ] MY DOG NEEDS TO BE MEASURED                                               HEIGHT AT WITHERS
                                                                                                                                       consequence of my (our) participation in this event, however such, injuries, death or property damage may be caused, and
                          [ ] MY DOG HAS A TEMPORARY JUMP HEIGHT FORM                                                                  whether or not the same may have been caused or may be alleged to have been caused by the negligence of the
                          [ ] MY DOG HAS A PERMANENT JUMP HEIGHT CARD                                                                  aforementioned parties or any of their employees, agents, or any other persons. I (WE) AGREE THAT ANY CAUSE OF
REGULAR STANDARD AGILITY                           REGULAR JUMPERS WITH WEAVES                  REGULAR FAST                           ACTION, CONTROVERSY OR CLAIM ARISING OUT OF OR RELATED TO THE ENTRY, EXHIBITION OR ATTENDANCE
(circle one)                         (circle one)                                               (circle one)                           AT THE EVENT BETWEEN THE AKC AND THE EVENT-GIVING CLUB (UNLESS OTHERWISE STATED IN ITS
NOV-A NOV-B OPEN         EXC-A EXC-B NOV-A NOV-B OPEN EXC-A EXC-B                               NOV-A NOV-B OPEN EXC-A EXC-B           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
JUMP HEIGHT (circle one)        8 12 16 20 24 26                                                                                       AMERICAN ARBITRATION ASSOCIATION. HOWEVER, PRIOR TO ARBITRATION ALL APPLICABLE AKC BYLAWS,
PREFERRED STANDARD AGILITY                         PREFERRED JWW                                PREFERRED FAST
                                                                                                                                       RULES, REGULATIONS AND PROCEDURES MUST FIRST BE FOLLOWED AS SET FORTH IN THE AKC CHARTER
                                                                                                                                       AND BYLAWS, RULES, REGULATIONS, PUBLISHED POLICIES AND GUIDELINES.
(circle one)                                    (circle one)                                    (circle one)
NOVICE-P OPEN-P EXC-AP            EXC-BP        NOVICE-P OPEN-P EXC-AP EXC-BP                   NOV-P OPEN-P EXC-AP           EXC-BP                                                   INSTRUCTIONS
JUMP HEIGHT (circle one)                 4    8 12 16 20                                                                               Handlers may opt to enter in a higher height division for all Regular titling classes, but not in a division
NON-REGULAR AGILITY CLASSES (if offered):               INTERNATIONAL SWEEPSTAKES CLASS                    JUMP HEIGHT (circle one)    lower than their proper height division. Dogs entered in the Preferred classes must compete at the
                                       (circle class) STD      JWW                                          14 18 26                   required jump height and may not compete in a jump height division higher or lower than their proper
                                                                                                                                       height division.
AKC® NAME (Include AKC titles only)                                                                       CALL NAME OF DOG             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
                                              (Enter number below)                    DATE OF BIRTH                                    Measuring Official, prior to running. If measured by the Judge of record, that measurement will be valid
[ ] AKC® NO.                                                                                                                           for this trial or back-to-back trials only. If a measurement is necessary, it is the exhibitor's responsibility
[ ] PAL/ILP NO.                                                                       PLACE OF BIRTH (LIST COUNTRY)                    to have their dog(s) measured prior to running.
[ ] FOREIGN REG. NO.
BREEDER
                                                                                                                                       Dogs enrolled in the AKC Canine Partners SM program may be eligible to enter all-breed AKC agility
                                                                                                                                       trials at the club’s option effective April 1, 2010. These dogs should be listed as All American Dog and
                                                                                                                                       must include their AKC number on the entry form and check the AKC No. box.
SIRE
                                                                                                                                       Junior Handlers should enter their Junior Handler number on the front of this form. Should you not have
                                                                                                                                       your Junior Handler number, it may be obtained from the American Kennel Club (919) 233-9767. If the
DAM
                                                                                                                                       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?
ACTUAL OWNERS                                                                                                                          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
OWNERS ADDRESS                                                                         NEW ADDRESS                                     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
CITY, STATE, ZIP + 4                                                                                                                   Rules and Regulations (including all provisions applying to discipline) and to abide by any decisions made in accord with
                                                                                                                                       them.
                                                                                                                                       SIGNATURE OF OWNER OR HIS AGENT DULY
HANDLER                                                IF JUNIOR HANDLER, PLEASE ENTER # BELOW FEE ENCLOSED                              AUTHORIZED TO MAKE THIS ENTRY

                                                                                                                                       TELEPHONE :

                                                                                                                                       E-MAIL ADDRESS:
            EXHIBITOR / OWNER MUST READ AND SIGN THE REVERSE SIDE OF THIS FORM.                                                                                                                                                                         AEAGL2 - (09/10)
                                                                                                                                       AKC Rules, Regulations, Policies and Guidelines are available on the American Kennel Club Web site, www.akc.org

                                             OFFICIAL ENTRY FORM FOR AGILITY TRIALS
                                                                                                                                                                                    AGREEMENT
                                              AMERICAN BELGIAN MALINOIS Club                                                           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
                                                           January 14, 15 & 16, 2011                                                   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
                       STD Classes:              Friday            Saturday             Sunday              All three days             of services that are necessary to hold this event and any employees or volunteers of the aforementioned parties, and any
                       JWW Classes:              Friday            Saturday             Sunday              All three days             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
       Entry fees: $23 for first entry (inc $3 AKC recording fee), $12 for second, same dog, same day (inc $3 AKC recording fee).      near any entrance thereto, and I (we) personally assume all responsibility and liability for any such claim; and I (we) further
          I would like a Trial Catalog ($8 pre-paid)          Mail all entries with fees (check or money order) payable to             agree to hold the aforementioned parties harmless from any claim for loss, injury or damage to this dog.
               Bluestem ATS to Lorah Marquardt, Trial Secretary, 1124 W River Dr, Stevens Point WI 54481
(IMPORTANT: CAREFULLY READ INSTRUCTIONS ON REVERSE SIDE BEFORE FILLING OUT)                                                            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
BREED                                                                   VARIETY
                                                                                                                                       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
SEX                       [ ] MY DOG NEEDS TO BE MEASURED                                               HEIGHT AT WITHERS
                                                                                                                                       whether or not the same may have been caused or may be alleged to have been caused by the negligence of the
                          [ ] MY DOG HAS A TEMPORARY JUMP HEIGHT FORM                                                                  aforementioned parties or any of their employees, agents, or any other persons. I (WE) AGREE THAT ANY CAUSE OF
                          [ ] MY DOG HAS A PERMANENT JUMP HEIGHT CARD                                                                  ACTION, CONTROVERSY OR CLAIM ARISING OUT OF OR RELATED TO THE ENTRY, EXHIBITION OR ATTENDANCE
REGULAR STANDARD AGILITY                           REGULAR JUMPERS WITH WEAVES                  REGULAR FAST                           AT THE EVENT BETWEEN THE AKC AND THE EVENT-GIVING CLUB (UNLESS OTHERWISE STATED IN ITS
(circle one)                         (circle one)                                               (circle one)                           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
NOV-A NOV-B OPEN         EXC-A EXC-B NOV-A NOV-B OPEN EXC-A EXC-B                               NOV-A NOV-B OPEN EXC-A EXC-B
                                                                                                                                       AMERICAN ARBITRATION ASSOCIATION. HOWEVER, PRIOR TO ARBITRATION ALL APPLICABLE AKC BYLAWS,
JUMP HEIGHT (circle one)        8 12 16 20 24 26                                                                                       RULES, REGULATIONS AND PROCEDURES MUST FIRST BE FOLLOWED AS SET FORTH IN THE AKC CHARTER
                                                                                                                                       AND BYLAWS, RULES, REGULATIONS, PUBLISHED POLICIES AND GUIDELINES.
PREFERRED STANDARD AGILITY                         PREFERRED JWW                                PREFERRED FAST
(circle one)                                    (circle one)                                    (circle one)                                                                           INSTRUCTIONS
NOVICE-P OPEN-P EXC-AP            EXC-BP        NOVICE-P OPEN-P EXC-AP EXC-BP                   NOV-P OPEN-P EXC-AP           EXC-BP   Handlers may opt to enter in a higher height division for all Regular titling classes, but not in a division
JUMP HEIGHT (circle one)                 4    8 12 16 20                                                                               lower than their proper height division. Dogs entered in the Preferred classes must compete at the
NON-REGULAR AGILITY CLASSES (if offered):               INTERNATIONAL SWEEPSTAKES CLASS                    JUMP HEIGHT (circle one)    required jump height and may not compete in a jump height division higher or lower than their proper
                                       (circle class) STD      JWW                                          14 18 26                   height division.
                                                                                                                                       All dogs that have not been officially measured for an Agility Jump Height Card may still compete;
AKC® NAME (Include AKC titles only)                                                                       CALL NAME OF DOG
                                                                                                                                       however, they must be measured by a Judge of record, an Agility Field Representative, or a Volunteer
                                                                                                                                       Measuring Official, prior to running. If measured by the Judge of record, that measurement will be valid
                                              (Enter number below)                    DATE OF BIRTH                                    for this trial or back-to-back trials only. If a measurement is necessary, it is the exhibitor's responsibility
[ ] AKC® NO.                                                                                                                           to have their dog(s) measured prior to running.
[ ] PAL/ILP NO.                                                                       PLACE OF BIRTH (LIST COUNTRY)
[ ] FOREIGN REG. NO.                                                                                                                   Dogs enrolled in the AKC Canine Partners SM program may be eligible to enter all-breed AKC agility
BREEDER                                                                                                                                trials at the club’s option effective April 1, 2010. These dogs should be listed as All American Dog and
                                                                                                                                       must include their AKC number on the entry form and check the AKC No. box.
SIRE                                                                                                                                   Junior Handlers should enter their Junior Handler number on the front of this form. Should you not have
                                                                                                                                       your Junior Handler number, it may be obtained from the American Kennel Club (919) 233-9767. If the
                                                                                                                                       Junior Handler is not the owner of the dog identified on the face of this form, what is the relationship of
DAM
                                                                                                                                       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
ACTUAL OWNERS                                                                                                                          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 above on this entry form. I (we)
OWNERS ADDRESS                                                                         NEW ADDRESS                                     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 accord with
CITY, STATE, ZIP + 4                                                                                                                   them.
                                                                                                                                       SIGNATURE OF OWNER OR HIS AGENT DULY
                                                                                                                                         AUTHORIZED TO MAKE THIS ENTRY
HANDLER                                                IF JUNIOR HANDLER, PLEASE ENTER # BELOW FEE ENCLOSED
                                                                                                                                       TELEPHONE :

                                                                                                                                       E-MAIL ADDRESS:

                                                                                                                                                                                                                                                        AEAGL2 - (09/10)
            EXHIBITOR / OWNER MUST READ AND SIGN THE REVERSE SIDE OF THIS FORM.

				
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