PREMIUM LIST Early Entries close 8:00pm Wednesday April 24, 2019 at 726683 Twp Rd 3, R R #2 Princeton, ON N0J 1V0 Canada Day of Trial entries close 30 minutes prior to roll call at the Field Secretary’s desk

Lake Country Lure Coursers

ASFA Lure

Region 9 ~ All Breeds And Lure Instinct

Saturday April 27 and Sunday April 28, 2019 Fort Niagara State Park Lewiston, NY

Permission has been granted by the American Field Association for the holding of this event under The American Sighthound Field Association Rules and Regulations.

Lee Warden, ASFA Scheduling Committee Audrey Silverstein, ENTRY FEES Early Entry Fees $20.00 US (25CDN)for first hound entered $15.00 US ($20 CDN) for additional hounds - same owner Day of Trial Entry Fee $25.00 ($30 CDN) for each hound entered

Online entries are available, but you MUST bring a completed ASFA entry form with you. US funds only with a $1 surcharge per entry. Link for online entries: https://www.formget.com/app/form/share/IUsw -329414 OR Email entries may be sent to the Secretary, with payment through PayPal (with a $1 surcharge per entry) or e-transfer (Cdn funds with no surcharge). OR Mail your entries with a check or money order.

LAKE COUNTRY LURE COURSERS OFFICERS

President………….. Dave McMahen Vice President………... Debbie Bell Secretary………….. Laurie Soutar Treasurer…………... Cathy Sanderson

JUDGES AND ASSIGNMENTS John Arvin 399 N. Main St.,Barnegat, NJ # Moyra Hamilton 39 Boulder Cr Guelph Ontario # Jeannie Martin 3553 Townline Road, Grassie, Ontario # = Canadian Judge S = Single Judge

SATURDAY Judge A Az Ba B C G Ib IW IG LCI P RR SA SD Sl SW Li W Si S S S S S S John X # # # # # # # # # # # # Moyra #  SUNDAY Judge A Az Ba B C G Ib IW IG LCI P RR SA SD Sl SW Li W Si John S S S S S S S S X S Moyra # # # # # # Jeanie # # # # #

FIELD COMMITTEE Field Trial Chairman: Cathy Sanderson Field Trial Secretary: Laurie Soutar 726683 Twp Rd 3, R R #2 Princeton, ON N0J 1V0 Canada Email: [email protected] Lure Operators: L. Chauvette, A. Osfolk, C. Sanderson, L. Soutar Roll Call & Inspection: 9:00 TRIAL HOURS 8:00AM UNTIL COMPLETION RIBBONS AND TROPHIES 1st Place - Blue Ribbon 2nd Place - Red Ribbon 3rd Place - Yellow Ribbon 4th Place - White Ribbon NBQ - Green Ribbon B.O.B. - Purple & Gold Rosette B.I.F. - Red White and Blue Rosette High Scoring Singles –Navy Blue & Gold. Entries will be acknowledged by email, provided that an legible email address is provided. Late, incomplete, unsigned or conditional entries will not be accepted. Eligible Breeds and Registries: Only purebred Afghan Hounds, Azawakhs, , , Cirneco dell’Etna, , Ibizan Hounds, Irish Wolfhounds, Italian Greyhounds, Pharaoh Hounds, Rhodesian Ridgebacks, , Scottish Deerhounds, Silken Windhounds, Sloughis, may be entered in the regular stakes. Limited breeds may be entered in the Limited Stake or the Singles Stake. Limited breeds currently include purebred Chart Polski, Galgo Español, Magyar Agar, Peruvian Inca Orchid, (Pequeno), Portuguese Podengo (Medio & Grande), and must be individually registered with the appropriate registry. All hounds entering Open, Veteran, or limited stakes for the first time MUST include a completed ASFA certification form or waiver form and a copy of the hound’s registration certificate

Hound certification runs will be offered after Best in Field and before Practice. Please allow extra time and postage for entries to cross the border. Late, incomplete, unsigned or conditional entries will not be accepted. Lunch will NOT be offered at this trial but there is a concession in the park or a sub shop near the park entrance.

All entries in the regular stakes shall be individually registered with the , AKC (ILP and PAL included), the United Kennel Club, the National Association, the Federation Cynologique Internationale, an ASFA-recognized foreign or ASFA Board approved registry, or possess a Critique Registration Number (CRN) from the Society for the Perpetuation of Desert Bred Salukis (SPDBS). Limited and/or Provisional stake entries shall be individually registered with the appropriate registry. A photocopy of acceptable registry must be submitted with a hound's first ASFA field trial entry; this requirement is waived for hounds registered with the National Greyhound Registry. Breed disqualifications apply. STAKES OFFERED OPEN STAKE any eligible sighthound, that have met the certification process. excluding ASFA Field Champions of record; FIELD CHAMPION STAKE: any ASFA Field Champion; VETERAN STAKE: any eligible hound that have met the certification process, whose age is at least six years, except Irish Wolfhounds whose age shall be at least five years, and Afghan Hounds, , Whippets and Rhodesian Ridgebacks, whose age shall be at least seven years. Points go toward V-FCh or V-LCM titles. LURE COURSING INSTINCT STAKE: Open to all breeds. All entries shall be individually registered with the AKC (including ILP & PAL), the UKC, the FCI, an ASFA recognized foreign or ASFA Board approved registry, or possess a CRN from the SPDBS. A photocopy of acceptable registry must be submitted with each dog’s first ASFA field trial entry. Dogs without a recognized registry number may obtain an ASFA ID number for a $10 registration fee at time of entry. This stake will be limited to a total of 10 entries. Small is for dogs shorter than 18 inches at the withers and / or brachycephalic (“flat-faced”) dogs. Large is for dogs over 18 inches at the withers. Small will run 50% of the course as laid out in this premium up to a maximum of 400 yards. All other sizes will run the full course length. SINGLES STAKE: Any eligible sighthound including those disqualified to run in other stakes. Not eligible for Best of Breed or Best in Field. Hounds are eligible to earn TCP and CPX titles from the Singles stake. Limited breeds are not eligible for these titles. LIMITED STAKE: Any eligible sighthound of a Limited breed that has met certification requirements. Not eligible to compete in Best of Breed or Best in Field.

Best in Field will be offered. CONDITIONS  Hounds must be 1 year of age or older on the day of the trial. Stakes will be split into flights by public random draw if the entry in any regular stake is 20 or more.  All hounds will run twice, in trios if possible or braces unless excused, dismissed or disqualified.  Bitches in season, hounds with breed disqualifications and lame hounds will be excused and the entry fee refunded. Hounds not present at roll call will be scratched.  Each entry will be examined at inspection for breed disqualifications. Spayed, neutered , cryptorchid, and monorchid hounds (without breed disqualifications) may be entered; hounds with breed disqualifications are not eligible to enter except in the Single Stake.  Battery powered, continuous loop lure system will be used. Backup equipment will be available. The lure will consist of white plastic strips.  The course will be reversed for the finals, and again for runoffs and Best of Breed.  Direction for Best in Field will be at the discretion of the judges.  Exhibitors are requested to not bring bitches known to be in season to the field.  A $5.00 fine will be assessed for any hound loose or interfering with the course in progress.  A $20.00 fine will be assessed to any owner not cleaning up after their hound.  Any person may, upon reasonable complaint, be asked to leave the grounds of the field trial by the Field Trial Committee  For more information go to www.lakecountrylurecoursers.com Lure Chasing Instinct Program Saturday All dogs entered must have a registration number via one of the following: A. AKC Registration as one of the recognized breeds. B. AKC Canine Partners, which is for mixed-breed dogs and dogs ineligible for AKC registration. C. Purebred Alternative Listing (PAL) program, which is for purebred dogs that cannot be fully registered with the AKC to participate in AKC events. D. Foundation Stock Service® (FSS), which is for recorded breeds on the road to full AKC recognition. E. United Kennel Club (UKC) registration as one of the recognized breeds. Complete the Lure Chasing Instinct Entry Form for those dogs who have registration numbers from either the AKC or Sunday UKC

F. If the dog has none of the above registrations, ASFA will provide a unique and permanent entry number for a one- time $10 charge. - The owner must complete the Request for Unique Entry Number Form for dogs those who do not have a registration number from either the AKC or UKC. - The Trial Secretary will submit a copy of the form with the records. - The owner will retain a copy as proof of request and payment until permanent number is provided.

For more information on this unique lure coursing opportunity go to http://lakecountrylurecoursers.com/wp- content/uploads/2019/03/ASFA-ALL-BREED-LCI-2019- 1.pdf

DIRECTIONS: Fort Niagara State Park is at the mouth of the Niagara River From the Queenston - Lewiston Bridge – bear right from customs. Exit at first right. Through Lewiston to route 93 (Youngstown). Turn left (west) onto route 93( =Youngstown Lockport Rd). Ends at Niagara River. Turn right (north) onto Main Street to Fort Niagara State Park entrance. No entrance fees if before 10am. Coursing field is behind a large man- made sledding hill on your right. From Niagara Falls, NY – 190 North to Rte 265 north for a short distance to Rte 104 north. Follow directions above.

Fort Niagara --- Latitude 43.263283 Longitude -79.053886 OFFICIAL AMERICAN SIGHTHOUND FIELD ASSOCIATION ENTRY FORM OFFICIAL AMERICAN SIGHTHOUND FIELD ASSOCIATION ENTRY FORM LCLC LCLC Saturday April 27, 2019 Sunday April 28, 2019 Early Entry fee: $20 first hound entered, Early Entry fee: $20 first hound entered, $15 - for second and any additional hounds - same owner $15 - for second and any additional hounds - same owner $25 Day of Trial Entry Fee $25 Day of Trial Entry Fee Entries close 8:00pm Wednesday April 25, 2019 Entries close 8:00pm Wednesday April 24, 2019 FTS – Laurie Soutar 726683 Twp Rd 3, R R #2 Princeton, ON N0J 1V0 Canada FTS – Laurie Soutar 726683 Twp Rd 3, R R #2 Princeton, ON N0J 1V0 Canada Please make checks payable to LCLC in U.S. funds Please make checks payable to LCLC in U.S. funds Fee Paid ______The Field Secretary cannot accept conditional, unsigned, incomplete or unpaid Fee Paid ______The Field Secretary cannot accept conditional, unsigned, incomplete or unpaid entries; please check your completed entry carefully. entries; please check your completed entry carefully. Breed: Call Name: Breed: Call Name:

Registered Name of Hound: Registered Name of Hound:

Stake: Additional Stakes Stake: Additional Stakes  Open  FCH  Veteran  Single  Limited  Kennel  Breeder  Bench  Open  FCH  Veteran  Single  Limited  Kennel  Breeder  Bench Registration Number: (please write in registering body before number) Registration Number: (please write in registering body before number)

 If possible, please Date of Sex:  If possible, please Date of Sex: separate my hounds Birth:  Dog  Bitch separate my hounds Birth:  Dog  Bitch Name of actual owner(s): Name of actual owner(s):

Address: Phone: Address: Phone:

City: State: Zip: City: State: Zip:

E-mail (Optional) (Optional) Region of Residence: E-mail (Optional) (Optional) Region of Residence:

Emergency Contact Name and Phone (Optional) Emergency Contact Name and Phone (Optional)

 Check if this is the first ASFA trial for this hound. Attach a Hound Certification or waiver if  Check if this is the first ASFA trial for this hound. Attach a Hound Certification or waiver if entered entered in Open, Veterans, Limited. in Open, Veterans, Limited.  Check if this is a first-time entry, a copy of the official Registration of this hound must  Check if this is a first-time entry, a copy of the official Registration of this hound must accompany accompany this entry unless NGA. this entry unless NGA.  Check if any information has changed since the last ASFA trial entry. Regarding ______ Check if any information has changed since the last ASFA trial entry. Regarding ______ Check if this hound has been dismissed within the last 6 trials entered. Must be marked in order to  Check if this hound has been dismissed within the last 6 trials entered. Must be marked in order to qualify qualify for a “clean” trial requirement. for a “clean” trial requirement.

I CERTIFY that I am the actual owner of this dog, or that I am the duly authorized agent of the actual owner I CERTIFY that I am the actual owner of this dog, or that I am the duly authorized agent of the actual owner whose whose name I have entered above. In consideration of the acceptance of this entry and the opportunity to have name I have entered above. In consideration of the acceptance of this entry and the opportunity to have this dog this dog judged and to win prize money, ribbons, or trophies, I (we) agree to abide by the rules and regulations of judged and to win prize money, ribbons, or trophies, I (we) agree to abide by the rules and regulations of the the American Sighthound Field Association in effect at the time of this lure field trial, and by any additional rules American Sighthound Field Association in effect at the time of this lure field trial, and by any additional rules and and regulations appearing in the premium list for this lure field trial. I (we) agree that the club holding this lure regulations appearing in the premium list for this lure field trial. I (we) agree that the club holding this lure field trial field trial has the right to refuse this entry for cause, which the club shall deem to be sufficient. I (we) agree to has the right to refuse this entry for cause, which the club shall deem to be sufficient. I (we) agree to hold this club, hold this club, its members, directors, governors, officers, agents or other functionaries, any employees of the its members, directors, governors, officers, agents or other functionaries, any employees of the aforementioned aforementioned parties and the owner(s) of the trial premises or grounds harmless from any claim for loss or parties and the owner(s) of the trial premises or grounds harmless from any claim for loss or injury which may be injury which may be alleged to have been caused directly or indirectly to any person or thing by the act of this dog alleged to have been caused directly or indirectly to any person or thing by the act of this dog while in or upon the while in or upon the lure field trial premises or grounds or near any entrance thereto and I (we) personally lure field trial premises or grounds or near any entrance thereto and I (we) personally assume all responsibility and assume all responsibility and liability for any such claim, and I (we) further agree to hold the aforementioned liability for any such claim, and I (we) further agree to hold the aforementioned parties harmless from any claim parties harmless from any claim loss of this dog by disappearance, theft damage or injury be caused or alleged to loss of this dog by disappearance, theft damage or injury be caused or alleged to be caused by the negligence of be caused by the negligence of the club or any of the aforementioned parties or by the negligence of any person the club or any of the aforementioned parties or by the negligence of any person or any other cause or causes. I or any other cause or causes. I (we) certify and represent that the dog entered is not a hazard to person or other (we) certify and represent that the dog entered is not a hazard to person or other dogs. This entry is submitted for dogs. This entry is submitted for acceptance of the forgoing representations and agreements. acceptance of the forgoing representations and agreements.

SIGNATURE of owner or his agent SIGNATURE of owner or his agent duly authorized to make this entry ______duly authorized to make this entry ______Please separate the entries before submitting to FTS. Please separate the entries before submitting to FTS. EF-A ~ rev 03-17© EF-A ~ rev 03-17 © AMERICAN SIGHTHOUND FIELD ASSOCIATION AMERICAN SIGHTHOUND FIELD ASSOCIATION HOUND CERTIFICATION HOUND CERTIFICATION Rule effective October 1, 1994: Ch. V, Sec. 4 (a) OPEN STAKE: To be eligible to enter Rule effective October 1, 1994: Ch. V, Sec. 4 (a) OPEN STAKE: To be eligible to enter the the open stake, a hound must have been certified by a licensed judge within the year open stake, a hound must have been certified by a licensed judge within the year preceding preceding the closing date for the entry or have previously competed in the Open Stake. the closing date for the entry or have previously competed in the Open Stake. This eligibility This eligibility requirement also applies to a hound entered in the Limited or Veteran Stake, requirement also applies to a hound entered in the Limited or Veteran Stake, which has not which has not competed in Open previously. Please complete this portion of this form and competed in Open previously. Please complete this portion of this form and attach it to the attach it to the entry form for the hound’s first entry, including an entry for a Fun Trial. entry form for the hound’s first entry, including an entry for a Fun Trial. Registered Name of Hound: Registered Name of Hound: Registration Number: ______Breed: Registration Number: ______Breed: Registered Owner’s Name: Registered Owner’s Name: I hereby certify that on (date) ______, the above named hound completed a I hereby certify that on (date) ______, the above named hound completed a lure course of at least 500 yards, running with another hound of the same breed (or another lure course of at least 500 yards, running with another hound of the same breed (or another breed with a similar running style). During the course the above named hound showed no breed with a similar running style). During the course the above named hound showed no inclination to interfere with the other hound. I further certify that I am a licensed judge for the inclination to interfere with the other hound. I further certify that I am a licensed judge for the ASFA. ASFA. Name of Licensed Judge: Name of Licensed Judge: Signature: Date: Signature: Date: I hereby certify that the hound running in the certification course is the hound identified I hereby certify that the hound running in the certification course is the hound identified above above and that information provided on this form is true and correct. and that information provided on this form is true and correct. Signature: Date: Signature: Date: Owner or Authorized Agent of Hound Owner or Authorized Agent of Hound This certification form must be attached to the entry form the first time this hound is entered in an open, limited, or veteran This certification form must be attached to the entry form the first time this hound is entered in an open, limited, or veteran stake. Any hound entered in open, limited, or veteran (as a first time entered hound), which has not been certified, shall be stake. Any hound entered in open, limited, or veteran (as a first time entered hound), which has not been certified, shall be declared ineligible by the records coordinator and shall forfeit any points and placements awarded. declared ineligible by the records coordinator and shall forfeit any points and placements awarded.

PLEASE RETAIN A COPY FOR YOUR RECORDS. PLEASE RETAIN A COPY FOR YOUR RECORDS. AMERICAN SIGHTHOUND FIELD ASSOCIATION AMERICAN SIGHTHOUND FIELD ASSOCIATION HOUND CERTIFICATION WAIVER HOUND CERTIFICATION WAIVER

Waiver of Requirement: This requirement will be waived for a hound that has earned a lure Waiver of Requirement: This requirement will be waived for a hound that has earned a lure coursing or racing from another recognized organization, if such title requires coursing or racing title from another recognized organization, if such title requires competition, competition, and if a waiver for such title has been approved by the ASFA, or a CKC Hound and if a waiver for such title has been approved by the ASFA, or a CKC Hound Certification Certification Form. If your hound qualifies for a waiver, complete this portion of this form and Form. If your hound qualifies for a waiver, complete this portion of this form and attach it to attach it to your entry form. Proof of waivers must accompany this certification form. your entry form. Proof of waivers must accompany this certification form.

Registered Name of Hound: Registered Name of Hound: Registration Number: ______Breed: Registration Number: ______Breed: Registered Owner’s Name: Registered Owner’s Name: CKC: FCH FCHX CKC: FCH FCHX AKC: QC SC FC AKC: QC SC FC Hound Certification previously submitted. Hound Certification previously submitted. I hereby certify that the hound identified above has completed the requirements for the title I hereby certify that the hound identified above has completed the requirements for the title indicated above (or that the required Certification was previously submitted) and that the indicated above (or that the required Certification was previously submitted) and that the information provided on this form is true and correct. information provided on this form is true and correct. Signature: ______Date: Signature: ______Date: Owner or Authorized Agent of Hound Owner or Authorized Agent of Hound

Sec-06 rev 01/19© Sec-06 rev 01/19© OFFICIAL AMERICAN SIGHTHOUND FIELD ASSOCIATION ENTRY FORM OFFICIAL AMERICAN SIGHTHOUND FIELD ASSOCIATION ENTRY FORM Lake Country Lure Coursers Lake Country Lure Coursers LURE CHASING INSTINCT LURE CHASING INSTINCT Saturday April 27, 2019 Saturday April 27, 2019 Early Entry fee: $20 rst hound entered, $15-for second and additional hounds-same owner Early Entry fee: $20 rst hound entered, $15-for second and additional hounds-same owner $25 Day of Trial Entry Fee - Entries close 8:00pm Wednesday April 25, 2019 $25 Day of Trial Entry Fee - Entries close 8:00pm Wednesday April 25, 2019 FTS – Laurie Soutar 726683 Twp Rd 3, R R #2 Princeton, ON N0J 1V0 Canada FTS – Laurie Soutar 726683 Twp Rd 3, R R #2 Princeton, ON N0J 1V0 Canada

Please make checks payable to LCLC in U.S. funds Please make checks payable to LCLC in U.S. funds

Fee Paid ______The Field Secretary cannot accept conditional, unsigned, incomplete or unpaid Fee Paid ______The Field Secretary cannot accept conditional, unsigned, incomplete or unpaid entries; please check your completed entry carefully. entries; please check your completed entry carefully.

Breed: (If known) or Mix Call Name: Breed: (If known) or Mix Call Name:

Registered Name of Dog: Registered Name of Dog:

Stake: (Choose one)  Lure Chasing Instinct Stake (for dogs that do not have LCJ or LCS titles) Stake: (Choose one)  Lure Chasing Instinct Stake (for dogs that do not have LCJ or LCS titles)  Lure Chasing Excellent Stake (only for dogs with LCJ and LCS titles)  Lure Chasing Excellent Stake (only for dogs with LCJ and LCS titles) Height at withers  Small height class: under 18” or any height brachycephalic (flat-faced dogs) Height at withers  Small height class: under 18” or brachycephalic (flat-faced dogs) (choose one class size)  Large height class: 18” and over (choose one size)  Large height class: 18” and over Registration Number: (please write in registering body before number) Registration Number: (please write in registering body before number)

 If possible, please Date of Sex:  If possible, please Date of Sex: separate my dogs Birth (if known:  Dog  Bitch separate my dogs Birth (if known:  Dog  Bitch Name of actual owner(s): Name of actual owner(s):

Address: Phone: Address: Phone:

City: State: Zip: City: State: Zip:

E-mail (Optional) Region of Residence: E-mail (Optional) Region of Residence:

Emergency Contact: Name and phone number (optional) Emergency Contact: Name and phone number (optional)

 Check if this is the first ASFA Lure Chasing Instinct trial for this dog.  Check if this is the first ASFA Lure Chasing Instinct trial for this dog.  Check if any information has changed since the last ASFA trial entry. Regarding ______ Check if any information has changed since the last ASFA trial entry. Regarding ______ Check if this dog has been dismissed within the last 6 trials entered. Must be marked in order to qualify for a  Check if this dog has been dismissed within the last 6 trials entered. Must be marked in order to qualify for a “clean” trial requirement. “clean” trial requirement.

I CERTIFY that I am the actual owner of this dog, or that I am the duly authorized agent of the actual owner whose name I I CERTIFY that I am the actual owner of this 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 and the opportunity to have this dog judged and to win have entered above. In consideration of the acceptance of this entry and the opportunity to have this dog judged and to win prize money, ribbons, or trophies, I (we) agree to abide by the rules and regulations of the American Sighthound Field prize money, ribbons, or trophies, I (we) agree to abide by the rules and regulations of the American Sighthound Field Association in effect at the time of this lure field trial, and by any additional rules and regulations appearing in the premium Association in effect at the time of this lure field trial, and by any additional rules and regulations appearing in the premium list for this lure field trial. I (we) agree that the club holding this lure field trial has the right to refuse this entry for cause, which list for this lure field trial. I (we) agree that the club holding this lure field trial has the right to refuse this entry for cause, which the club shall deem to be sufficient. I (we) agree to hold this club, its members, directors, governors, officers, agents or other the club shall deem to be sufficient. I (we) agree to hold this club, its members, directors, governors, officers, agents or other functionaries, any employees of the aforementioned parties and the owner(s) of the trial premises or grounds harmless from functionaries, any employees of the aforementioned parties and the owner(s) of the trial premises or grounds 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 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 upon the lure field trial premises or grounds or near any entrance thereto and I (we) personally assume of this dog while in or upon the lure field trial premises or grounds or near any entrance thereto and I (we) personally assume all responsibility and liability for any such claim, and I (we) further agree to hold the aforementioned parties harmless from all responsibility and liability for any such claim, and I (we) further agree to hold the aforementioned parties harmless from any claim loss of this dog by disappearance, theft damage or injury be caused or alleged to be caused by the negligence of the any claim loss of this dog by disappearance, theft damage or injury be caused or alleged to be caused by the negligence of the club or any of the aforementioned parties or by the negligence of any person or any other cause or causes. I (we) certify and club or any of the aforementioned parties or by the negligence of any person or any other cause or causes. I (we) certify and represent that the dog entered is not a hazard to person or other dogs. This entry is submitted for acceptance of the forgoing represent that the dog entered is not a hazard to person or other dogs. This entry is submitted for acceptance of the forgoing representations and agreements representations and agreements

SIGNATURE of owner or his agent duly authorized to make this entry ______SIGNATURE of owner or his agent duly authorized to make this entry ______ET – A ~ Rev 2 – 19 © ET – A ~ Rev 2 – 19 ©

OFFICIA ASFA Request for Unique Entry Number FORM OFFICIA ASFA Request for Unique Entry Number FORM Lake Country Lure Coursers Lake Country Lure Coursers This form is for dogs that DO NOT have a registration number This form is for dogs that DO NOT have a registration number

$10 per dog for a Unique Entry Number. This one-time fee is separate from the entry fee. $10 per dog for a Unique Entry Number. This one-time fee is separate from the entry fee. Fee Paid ______Fee Paid ______

Breed: (If known) or Mix Call Name: Breed: (If known) or Mix Call Name:

Name of Dog as you would like it registered Name of Dog as you would like it registered

FTS will check correct class size after  Small height class: under 18” or brachycephalic (flat-faced dogs) FTS will check correct class size after  Small height class: under 18” or brachycephalic (flat-faced dogs) wicketing at inspection,  Large height class: 18” and over wicketing at inspection,  Large height class: 18” and over Registration Number: (temporary number assigned by Trial Secretary) Registration Number: (temporary number assigned by Trial Secretary)

Date of Birth (if known): Sex: Date of Birth (if known): Sex:  Dog  Bitch  Dog  Bitch Name of actual owner(s): Name of actual owner(s):

Address: Phone: Address: Phone:

City: State: Zip: City: State: Zip:

E-mail (Optional) (Optional) Region of Residence: E-mail (Optional) (Optional) Region of Residence:

Emergency Contact: Name and phone number (optional) Emergency Contact: Name and phone number (optional)

This top portion is to be submitted with the $10 Unique Entry Number Form and Lure Chasing Instinct Form. This top portion is to be submitted with the $10 Unique Entry Number Form and Lure Chasing Instinct Form.

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

______was entered in the ______was entered in the (Dog’s name) ASFA Club initials (Dog’s name) ASFA Club initials

ASFA trial held on (date)______. The dog was wicked at inspection and is ASFA trial held on (date)______. The dog was wicked at inspection and is registered as a Class Size ______. The fee of $10 was received by the FTS registered as a Class Size ______. The fee of $10 was received by the FTS and submitted to the ASFA Records Coordinator. and submitted to the ASFA Records Coordinator.

Printed name of Field Trial Secretary: ______Printed name of Field Trial Secretary: ______

Signature of Field Trial Secretary: ______Signature of Field Trial Secretary: ______

(Owner is to retain this receipt as proof of registration until notified by the ASFA) (Owner is to retain this receipt as proof of registration until notified by the ASFA)

ET – A ~ Rev 2-19 © ET – A ~ Rev 2-19 ©