Trial
Entry Form
Mountain Empire Schutzhund Club
Knoxville, Tenn.
March 5-6, 2005
Check the trial entering:
SchH 1
SchH 2
SchH 3
BH
OTHER_________ |
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Directions: Exit 392 off I-40 in Knoxville
north on 11W(Rutledge pike) 16 miles to Lake Valley Ranch sign on your
left
go 1.2 miles and turn left then .2 miles to gravel road thru gate
the
schutzhund field will be at the end of the road on your right
you will
go thru the town of Blaine before you get to the farm.
12-dog limit on schutzhund
entries due to tracking space
Entry fee $60 SchH; $40 BH
Mail entry and fees to:
Vicki Keller
830 Bluff Drive
Knoxville, TN 37919
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Dog's registered name_______________________________________Titles________________________
Breed: _______________________________________________
Sex: ___________________________
Date of Birth:____________________________________
Tattoo #: ______________________________
Registration #: _______________________
Registry: ________________________________________
Scorebook #: __________________________________
Titles: _________________________________
Sire:___________________________________________________
Title(s):_______________________
Dam:___________________________________________________
Title(s):_______________________
Breeder: ______________________________________________________________
Owner/Handler:________________________________________________________________________
Address:______________________________________________________________________________
City: _____________________________________________
State: ______ Zip: __________________
Club membership: USA DVG AWDF
Member Club name___________________________________
USA Local Club Affiliations:______________________________________
USA Membership #: _________________________
Email Address: ______________________________
Day Phone: ______________________________
Evening Phone: _______________________________
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Read the following statements carefully:
It
is hereby understood that every dog at this trial will be under the direct
care and control of its handler. The undersigned agrees to be fully responsible
for any and all actions of their dog, including dogs owned by another but
in the undersigned's care, and to hold harmless all members, officers
and directors of the host club, the United Schutzhund Clubs of America,
and any property owners associated with this event in case of accident
or injury. I hereby assume all responsibilities and liabilities for
myself and my dogs and agree to abide by all USA guidelines and rules.
Owner/ Handler/ Agent _________________________________Date_____________
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