PBGA Official Entry
Form
Note: This entry form must be completed in full
Club
Hosting Event: _______________________ Date of Event: __________________
Club
Location: ________________________________________________________________
I submit
$______ for entry fees.
Enter
in stake/test: __________________________________________________________
BEAGLE
ONLY Male £ Female £ 13”
Class £ 15”
Class £
Name of
Dog
(print) |
|
|
AKC
Reg Number
|
OR
AKC Litter Number (if dog not reg.) |
|
OR Foreign Reg.Number |
AND
Country Of Registry |
|
Breed |
Male
£ Female £ |
Date
of Birth |
|
|
Sire |
|||
|
Dam |
|||
|
Breeder |
|||
|
Name
of Actual Owner
(print) |
|||
|
Owner’s
Street Address |
|||
|
City |
State |
Zip |
|
|
Name
of Handler (print) |
|||
|
Phone
# |
Email: |
||
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, I agree to abide by all the Rules and Regulations of the American Kennel
Club governing this Field Trial and any decisions made in accord with them, and
I further agree that the dog is entered in and will be at this event at my own
risk and that I will hold the event giving club, its members and agents free
from liability for any claims arising out of the entry of the dog or its
presence at the event.
Signature
of Owner or Agent Duly
Authorized
to Make This Entry_____________________________________________________
Address
of Agent (if Agent signs above line for owner): Phone
Number____________________
Street ___________________________________City ________________________________
State ________ Zip Code
__________________ Email: ______________________________