Inner City Working Dog Club

Spring Club Trial Entry Form

Date: May 9 – 10

UScA Judge: Don Yelle

Please complete all boxes on the entry form exactly how you want it to appear in the paperwork.

Once your form has been received, the trial secretary will email you instructions on how to make payment for your entry.

ENTRIES ARE NOT CONSIDERED COMPLETE UNTIL PAYMENT IN FULL HAS BEEN RECEIVED.

You will receive a second email confirming that your entry is completed with payment.

YOU MUST BRING YOUR USCA MEMBERSHIP CARD AND DOG’S SCOREBOOK WITH YOU TO THE TRIAL –

NO EXCEPTIONS.

A microchip reader will be provided by ICWDC

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Dogs Registered Name

Dogs Titles

Dogs DOB

Male / Female(required)

Male Female

HOT

Breed

Registration #

Microchip / Tattoo #

Scorebook #

Sire

Dam

Handlers Full Name

UScA #

Expiration

Date and Org where BH obtained (Type “none” if handler’s first BH)

Handlers Address

Handlers City

Handlers State

Handlers Zip

Handlers Email

Handlers Phone

Owners Full Name (if different)

UScA #

Expiration

Owners Address

Owners City

Owners State

Owners Zip

Owners Email

Owners Phone

Payment Preference – the trial secretary will send further instructions

INFORMED CONSENT AND RELEASE

It is hereby understood that every dog at this event will be under the direct care and control of its handler. The undersigned agrees to be fully responsible for any and all actions of their dog, including owned by another but in the undersigned’s care, and to hold harmless all members, officers and directors of Inner City Working Dog Club and any property owners associated with this event in case of accident, injury or death, either to oneself or one’s dog and loss of property. Any and all protests must be submitted in writing to the Trial Secretary only.
SUBMISSION OF THIS FORM SERVES AS CONSENT TO THE ABOVE STATEMENT AND ACTS AS DIGITAL SIGNATURE.