Northeast K9 Saratoga Springs, New York

Northeast K9 – Saratoga Springs, New York 2017Spring Trial with USCA Don Yelle September 23rd, 2017

For questions/information contact – Laurie Coppola 518-522-0988 (c) Mail entries to Trial Secretary – Laurie Coppola, 123 Edie Road, Saratoga Springs, NY 12866 or email to [email protected] ______USCA Member Entry Fees for Each title is $70.00, except BH and AD which are $60 * Non-USCA Member Entry Fees for all titles is $95.00

TITLE ENTERED FOR:______

Make checks payable to – Northeast K9, or Paypal entry fee to [email protected], Full payment must accompany entries

 Include a late fee of $15.00 on entries received after September 18th - NO refunds will be allowed  Complete the entry form neatly and carefully; and clearly identify an alpha O/numeric 0 (where appropriate)  Remember to bring – scorebook, current rabies certificate, USA member card, and microchip reader (if applicable)  Only dogs competing in this event are allowed on the trial grounds ______

Handler's Name______Email______

Phone # (Home) ______(Cell) ______HOT – Y______N______

Address______

Scorebook # (SV, USA, Other) ______USCA Member#______Expiration______

ALL ENTRIES EXCEPT BH - Date & Place BH Earned______

BH ONLY - Do you need to complete a written exam? Y____N____If No – Date & Place Exam Taken______

Dog’s Registered Name______Breed______

Sex - M____F____Date of Birth______Current Titles______Hot: Yes____No____

Registration #______Tattoo ______Microchip#______

Owner’s Name (if other than handler)______

RELEASE STATEMENT: I, the undersigned, certify that I am the actual owner of this dog or that I am duly authorized by the owner of this dog to act as his or her agent and the dog’s handler. In consideration of the acceptance of this entry, I agree to abide by the rules of Schutzhund USCA and Northeast K9, and to follow all instructions issued by the Trial Chairperson and/or the Trial Judge. It is understood that every dog at this event, will at all times, be in the care and control of the dog’s named owner/handler. It is further understood that the undersigned agrees to be fully responsible for the actions of his or her dog while on the trial grounds. I agree to release Northeast K9, its members, officers, agents and directors, as well as any ground or property owners, from any and all liability of any nature; for injury or damage resulting from the action of any dog, any person, or any other thing; and I hereby agree to personally assume all risk of such damage or injury while attending this function or while on the grounds or surrounding areas. It is understood that the Trial Chairperson has the right to dismiss any dog/handler team for violations of the rules or unsportsmanlike conduct; in which case entry fees will not be refunded. I have been duly authorized to make this entry and hereby agree to the conditions of the Release Statement.

Signature of Handler ______Date______

Signature of Owner______Date ______