OFFICIAL AMERICAN KENNEL CLUB ENTRY FORM
Note: This entry must be completed in full (Chap. 9 Sec. 3)

PLEASE ENTER INFORMATION IN THE SPACES BELOW- - One entry form per dog per stake

ENCLOSE $ for entry fee in: JUNIOR SENIOR MASTER

FULL NAME OF DOG
Call Name
A.K.C. REGISTRATION NUMBER OR A.K.C. LITTER NUMBER
OR
FOREIGN REGISTRATION NUMBER AND COUNTRY OF REGISTRY
BREED Chesapeake Bay Retriever Golden Retriever Irish Water Spaniel Labrador Retriever Standard Poodle   Male Female
DATE OF BIRTH

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Month   Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31  

BREEDER
SIRE
DAM
ACTUAL OWNER(S)
OWNER’S ADDRESS
Address of owner(s)

CITY STATE WA UT OR MT ID CA AK ZIP CODE


Name of Handler: Brad Turner (Stillmotion Kennels)
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 and the Standard Procedures governing this Hunt Test and any decisions made in accord with them and I further agree that the dog is entered in and will be at this trial at my own risk and that I will hold the event-giving club, its members and agents free from liability for any claims arising out of the entry of the dog or its presence at the event.

SIGNATURE ___________________________________________ TELEPHONE (360) 629-3111
of owner or his agent duly authorized to make this entry.

Address of Agent (If any signs the above line for Owner)
Street: P. O. Box 503    Phone: (360)629-3111
City, State: Stanwood, WA    Zip: 98292-0503

I wish to have my running order sent me by e-mail at this address: dogs@camano.net