OFFICIAL UNITED KENNEL CLUB CONFORMATION ENTRY FORM

OFFICIAL UNITED KENNEL CLUB CONFORMATION ENTRY FORM

Please print or type all information. Do not complete this form until you have read and signed the waiver.

Armband Number:

Invalid without signature.

dog weight:

Host Club (do not abbreviate)

IMPORTANT INFORMATION ABOUT THIS ENTRY FORM:

1. All entries must be submitted on the current "current official UKC? entry form". You may

Date Show 1 Show 2

Date Show 1 Show 2

Date Show 1 Show 2

Date Show 1 Show 2

use one entry form to enter the same dog in more than one show on the same weekend. 2. Use a separate entry form for each dog. 3. Mail all completed entry forms to the Event Secretary listed under the event, unless

otherwise specified. Make checks payable to host club.

Dog must not be entered without a permanent UKC? registration number or a UKC? Temporary Listing number. Check one of the two boxes below and enter your dog's number. If your dog's permanent registration is pending at UKC, and you do not have a valid TL number, your entry will be invalid.

4.

We want you to keep the points earned at UKC Licensed events. Important things to remember:

? Dog not UKC registered? Apply for a Temporary Listing Number (TL) online at tl-numbers.(TL fees are non-refundable, non-transferable and do not apply to the cost of permanent registration.)

Dog's UKC Permanent or TL #:

? All dogs entering UKC events must be permanently registered or have a valid Temporary Listing Number.

Breed of dog:

Variety (if applicable):

Sex:

? All entry forms must be completed and signed. Incorrect information submitted on the entry form may invalidate your wins.

Dog's Name:

? To be eligible to enter into the Breeder/Handler class, you must be one of the breeders of record, or a member of the immediate family of one of the breeders of record.

Call Name:

Date of Birth:

Immediate family includes: spouse, parent, step-parent, child, step-child, sibling, grandchild, or in-law, so long as the handler is not a professional handler as defined

Dog owner's name(s):

by UKC Rules and Regulations. 5. The United Kennel Club complies with the Americans with Disabilities Act. If you require

Address:

an accommodation, please contact the Event Chair or Secretary for this club's event.

UKC Entry Waiver

City: Phone:

Email:

State:

ZIP

Please check the box for the appropriate class

Conformation (Only Choose One) Puppy (6 months-under 1 year) Junior (1 year-under 2 years) Adult (2 years & over) Open (6 months & over) Breeder & Handler (6 months & over shown by breeder) Champion (CH) Grand Champion (GRCH)

Altered Conformation (Only Choose One) Puppy (6 months-under 1 year) Junior (1 year-under 2 years) Adult (2 years & over) Open (6 months & over) Breeder & Handler (6 months & over shown by breeder) Champion (CH) Grand Champion (GRCH)

Non-Licensed Classes Novice Puppy Veteran Brood Bitch/Stud Dog Brace Total Dog Other:

Total Dog

All events are held under the Official Rules and Regulations of the United Kennel Club. Absolutely no illegal drugs or firearms will be allowed on the grounds or in the buildings on the day of a UKC Licensed event. UKC, its agents and employees, and the host club assume no responsibility for any loss, damage, or injury sustained by spectators or by exhibitors and handlers, or to any of their dogs or property, and further assume no responsibility for injury to children not under the control of their parents or guardians. UKC and the host club are not responsible for loss, accidents or theft.

By signing this form, I hereby agree to release, waive, discharge and covenant not to sue UKC, its judges, officers, employee and agents and the host club from liability arising from any claim, action, or lawsuit, including the negligence of the UKC, its judges, officers, employee and agents, and further agree to indemnify and hold UKC, the host club and any approved UKC Judge harmless from any claims, actions or lawsuits, including attorneys' fees, resulting from my participation in this event, and any action, decision or judgment made by any UKC or host club representative or approved Judge under the official UKC Rules and Regulations governing this event. I acknowledge that the current Official UKC Rules and Regulations (Agility, Conformation, Dock Jumping, Drag Racing, Junior Showmanship, Lure Coursing, Obedience, Rally Obedience, Weight Pull, Precision Coursing) have been made available to me, and that I am familiar with their contents. My signature indicates that I understand and agree to the above and to abide by all of the current Official UKC Rules and Regulations.

I have read this waiver of liability, assumption of risk, and indemnity agreement, fully understand its terms, and understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing the agreement freely and voluntarily and intend by my signature to be a complete and

unconditional release of all liability to the greatest extent allowed by law.

I have read and agree to the waiver on this form. I swear that this dog is not being handled by a professional handler in Conformation.

Entry Fee:

Signature of Owner/Handler

Date

If owner is a minor/Signature of Parent or Guardian

Date

FO136FBL Updated 11-23

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