Event #

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E
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AND FOR COMPLETING ENTRY
  Entry Fees Total +    Conv Fees Total =    All Fees Total 
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PAYMENT
METHOD
Signature: 
Required Signature is the
TYPED NAME of Applicant
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 premium list for this event, and further agree to be bound by the "Agreement" printed on the reverse side of 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 Regulations (including all provisions applying to discipline) and to abide by any decisions made in accord with them.

Breed&
Variety:
Sex:
Division:

Full
Name
of Dog:
Dog Height
Date of Birth:
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Only Use
Date Picker
For Entry
of DATES
Place
of Birth
Do not print above in catalog
REGISTRATION NUMBER
BREEDER:
SIRE:
DAM:
Phone
email
Personal Entry ID
Agent (If any)
Actual Owner(s)
Owners Address
?
NON USA addresses should be placed entirely in the ADDRESS FIELD on ONE LINE including Country.
There is no need to use the CITY STATE ZIP fields for NON USA addresses.
City
State
Zip
1) FIRST SELECT EVENT or SELECT ALL EVENTS
EACH SUBMITTAL WILL BE REDIRECTED FOR PAYMENT, THERE IS NO SHOPPING CART
( If submitting multiple forms, request PAYPAL INVOICE for One Combined Payment )
2) FIRST ENTRY - Conformation~Breed
 
SECOND ENTRY - Conformation~Breed
 
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SELECT CLASSES
FROM
DROP-DOWN MENUS
 
Sweepstakes
 
Junior Showmanship
 
Junior Name
     
Junior Number
Junior Date
of Birth
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Only Use
Date Picker
For Entry
of DATES
Juniors Addresss and City~State~Zip (all on one line)
Junior Relation
to Dog Owner
     
FIRST ENTRY - Obedience
Jump Height
     
 
SECOND ENTRY - Obedience
 
ADDITIONAL ENTRY - Obedience
 
FIRST ENTRY - Rally
Jump Height
     
 
SECOND ENTRY - Rally
 
ADDITIONAL ENTRY - Rally
 
MISC ENTRY - Any Classes  Two Fields Available
( Can be Used for Additional Classes at Entry Fee + Conv Fee, as Needed )
 Enter Fees Here
Conv Fee
Entry Fee
Conv Fee
Entry Fee
Design/Copyright Richard Seeno, Picalo SW
 2022-05-18   2022-05-18 17:00:00 
Brd: En2: Jrs: Swp: Obd: Rly: Msc: