AKC Herding Entry Form
If you are having a problem with the fill-able forms, you may use the following form. If you use this form, please check to make sure it was delivered correctly.
This is a very simple form, please fill in all pertinent information in appropriate boxes.
- Please consult Premium List for information. In Most cases all the information requested is REQUIRED in order to submit the form
- Because the form is simple, the error message does not tell you what part is missing.
- The following fields are Required:
- Club, Date, Breed
- Dog's Registered Name
- Dog's Registration number
- DOB, Sex
- Breeder, Sire & Dam
- Owner(s) Name, Address, City State, Zip
- Owner or Agent Type Name, Phone, and Email.
You will also need to calculate amount due, and remember to add the $4.00 per entry per event.
Payment Two choices: Submit payment through PayPal, click on send money, and send to LnRRigB@cox.net
or use Virtual Terminal (only available August & September)
accepted credit cards: MASTER CARD, VISA, AMERICAN EXPRESS, directions are on payment form.
Club
Date(s)
Breed
Variety
Sex
Please check all that applies
Comments
Dog's Registered Name
Dog's Registration Number
Please check one that applies
If Foreign Please identify County
Date of Birth
Place of Birth
Breeder
Sire
Dam
Actual Owner(s)
Address
City
State
Zip Code
Dog's Call Name
Full Name of Agent (if Any) at Show
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.
Owner or Agent Type NameFull Name of Agent (if Any) at Show
Phone
Cell
Fax
Email
AGREEMENT
I (we) agree that the club holding this event has the right to refuse this entry for cause which the club shall deem sufficient. In consideration of the acceptance of this entry and of the holding of this event and of the opportunity to have the dog judged and to win prizes, Rosettes, or trophies, I (we) agree to hold the AKC, the event-giving club, their members, directors, governors, officers, agents, superintendents or event secretary and the owner and/or lessor of the premises and any provider of services that are necessary to hold this event and any employees or volunteers of the aforementioned parties, and any AKC approved judge, judging at this event, 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 of this dog while in or about the event 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 any claim for loss, injury or damage to this dog. Additionally, I (we) hereby assume the sole responsibility for and agree to indemnify, defend and save the aforementioned parties harmless from any and all loss and expense (including legal fees) by reason of the liability imposed by law upon any of the aforementioned parties for damage because of bodily injuries, including death at any time resulting there from, sustained by any person or persons, including myself (ourselves), or on account of damage to property, arising out of or in consequence of my (our) participation in this event, however such, injuries, death or property damage may be caused, and whether or not the same may have been caused or may be alleged to have been caused by the negligence of the aforementioned parties or any of their employees, agents, or any other persons. I (WE) AGREE THAT ANY CAUSE OF ACTION, CONTROVERSY OR CLAIM ARISING OUT OF OR RELATED TO THE ENTRY, EXHIBITION OR ATTENDANCE AT THE EVENT BETWEEN THE AKC AND THE EVENT-GIVING CLUB (UNLESS OTHERWISE STATED IN ITS PREMIUM LIST) AND MYSELF (OURSELVES) OR AS TO THE CONSTRUCTION, INTERPRETATION AND EFFECT OF THIS AGREEMENT SHALL BE SETTLED BY ARBITRATION PURSUANT TO THE APPLICABLE RULES OF THE AMERICAN ARBITRATION ASSOCIATION. HOWEVER, PRIOR TO ARBITRATION ALL APPLICABLE AKC BYLAWS, RULES, REGULATIONS AND PROCEDURES MUST FIRST BE FOLLOWED AS SET FORTH IN THE AKC CHARTER AND BYLAWS, RULES, REGULATIONS, PUBLISHED POLICIES AND GUIDELINES.
INSTRUCTIONS
1. (Variety) if you are entering a dog of breed in which there are varieties for show purposes, please designate the particular variety you are entering, i.e., Cocker Spaniel (solid color black, ASCOB, parti-color), Beagles (not exceeding 13in., over 13 in. but not exceeding 15 in.), Dachshunds (longhaired, smooth, wirehaired), Collies (rough, smooth), Bull Terriers (colored, white), Manchester Terriers (standard, toy), Chihuahuas (smooth coat, long coat), English Toy Spaniels (King Charles and Ruby, Blenheim and Prince Charles), Poodles (toy, miniature, standard).
2. The following categories of dogs may be entered and shown in Best of Breed competition: Dogs that are Champions of Record and dogs which, according to their owners’ records, have completed the requirements for a championship, but whose championships are unconfirmed. The showing of unconfirmed Champions in Best of Breed competition is limited to a period of 90 days from the date of the show where the dog completed the requirements for a championship.
3. (Event Class) Consult the classification in this premium list. If the event class in which you are entering your dog is divided, then, in addition to designating the class, specify the particular division of the class in which you are entering your dog, i.e, age division, color division, weight division.
4. A dog must be entered in the name of the person who actually owned it at the time entries for an event closed. If a registered dog has been acquired by a new owner it must be entered in the name of its new owner in any event for which entries closed after the date of acquirement, regardless of whether the new owner has received the registration certificate indicating that the dog is recorded in his name. State on entry form whether transfer application has been mailed to the AKC. (For complete rules, refer to Chapter 11, Section 3.)
If this entry is for Junior Showmanship, please give the following information:
Junior's Date of Birth
AKC Junior Handler Number
The above number MUST be included. Should you not have your Junior Handler number, this may be obtained from the American Kennel Club. Phone: (919) 816-3776.
By checking
on this entry form I (we) certify that the Junior Showman does not now, and will not at any time, act as an agent/handler for pay while continuing to compete in Junior Showmanship.
If Junior Handler is not the owner of the dog identified on the face of this form, what is the relationship of the Junior Handler to the Owner?
Address
City
State
Zip Code
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