KENNEL ASSOCIATION OF GOA

Dobermann, & Retriever (Labrador) Specialty Shows At Fire Services Ground, Panaji, Goa, on Saturday 26th October 2013

Note: Please type or write clearly in block letters. Photo copy of this form, or KCI approved entry form will be accepted. Compulsorily enclose photo copy of both sides of the K.C.I Registration Certificate.

BREED: ______ENTERED IN CLASSES:______

NAME: ______KCI. REG. NO.:______

BORN: ______SEX: ______

SIRE:______DAM:______

OWNER: ______BRED IN INDIA/IMPORTED (strike wrong option)

BREEDER: ______

OWNER’S ADDRESS: ______E-MAIL: ______

PH/MOBILE NO.: ______SIGNATURE: ______

To The President Kennel Association of Goa

Dear Sir

I am enclosing my entries for the Dobermann, Rottweiler & Retriever (Labrador) Specialty Shows to be held at Goa as per following details: Cash/ DD

Fee per per class GRAND per Show @ Rs.500/- TOTAL Rs.

Please read the Show Schedule and K.C.I. Rules and Regulations for Shows, carefully.

DECLARATION BY THE OWNER I/We hereby certify that the dog/s entered above is my/our bonafied property and I/We enter them at our risk & that the dog entered on this form is registered in India, ONLY with of India. I/we further declare that our champion dog has been only entered in the champion class and not in any other class. I/We undertake and abide by the rules and regulations and bylaws of the and of this show & I/We declare that the dog entered has not suffered from or been exposed to the risk of DISTEMPER or any other contagious or infectious disease for six weeks prior to exhibition. I/We will not show them if they incur any such risk between now and the day of the show, or if they have been inoculated with distemper virus within fourteen days prior to the show. IMPORTANT NOTICE TO EXHIBITORS entered are entirely at OWNERS risk, the KAG, KCI, its delegates or representatives is not responsible for any untoward incidents.

Name …………………………… Signature ……………………………