You may Print Out this form and use it to mail your Entry BEFORE closing.
All Fees and SASE must be received in a timely manner. Thank You.

Do Not Write in This Space                                  Received Date: _____________ 
|| Entry Fee [   ]   ||   Total ______   || SASE? [   ] ||  Date Returned ____________
OFFICIAL AMERICAN KENNEL CLUB ENTRY FORM
CLUB:
INLAND WILDERNESS HUNT CLUB
Other ....................................................
DATE(S)
[  ] .......................................
[  ] .......................................
SEC/ADDR:     Dixie Hirsch, P.O. Box 777, Silverado, CA 92676
Phone/FAX (714) 649-2770  || On-Line: www.sunstag.org/IWHC/index.html
Entries Close:

Add $2.00 per entry for On-Line.
Pre-Entry Test/Trial Fees:
Day-of Test/Trial Fees:
Move-Up Fees:
I Enclose $ ...................................... for Entry Fees.
ENTRY FOR:  [  ] Test    [  ] Trial        [  ] Move Up
                        [  ] Open  [  ] Special   [  ] Veteran 
Hound dismissed within the last six Trials?  [  ]
Breed
Date of Birth
SEX:
      Dog        Bitch 
Call Name
Registered Name
Enter Numbers Here
[  ] AKC Reg. No.
Breeder(s)
[  ] ILP No.
Sire
[  ] For. Reg. No./Country
Dam
Actual Owner(s)
Ownership Change [  ]
Owner's Address
Address Change
[  ]
City/State/Zip
Name of Owner's Agent (if any) at Trial:

I Certify That I am the actual owner of the hound, 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 trial, and by any additional Rules and Regulations appearing in the Premium List for this Trial, 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.
Signature of Owner or his Agent duly Authorized to Make this Entry:
[  ] Please Separate
      My Entries.		 Telephone:
 Pers. I.D. No.:

The print-out of this form could be over-sized. It does cover the required data and is as close a facsimile as possible.
Best when used from Internet Explorer; 2 pages.

 

This portion is NOT required.



Single copies of the latest edition of the "Rules Aplying to Registration
and Dog Shows" and "Lure Coursing Trial Regulations"
may be obtained without charge from any Secretary at a Trial
where they are officiating or from:
THE AMERICAN KENNEL CLUB, 51 MADISON AVENUE, NEW YORK, NY 10010.


AGREEMENT

#   I(We) acknowledge that the "Rules Applying to Registration and Dog Shows" and, if this entry is for a lure coursing trial, the "Lure Coursing Trial Regulations", have been made available to me(us), and that I am (we are) familiar with their contents. I(We) agree that the club holding this trial has the right to refuse this entry for cause which the Club shall deem to be sufficient, in consideration of the acceptance of this entry and of the holding of the trial and of the opportunity to have the hound judged and to win prize money, ribbons, or trophies. I(We) agree to hold this club, its members, directors, govenors, officers, agents, superintendents or show secretary and the owner or lessor of the premises and any employees of the aforementioned parties, harmless from any claim for loss or injuiry 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 upon the show or trial premises or ground 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 for damage or injury to the dog, whether such loss, disappearance, theft, damage or injury, be caused or alleged to be caused by the negligence of the Clubor any of the parties aforementioned, or by the negligence of any other person, or any other cause or causes.
#   I(We) hereby assume the sole responsibility for and agree to indemnify and hold the aforementioned parties 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 therefrom, 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 trial, howsoever such injuries, death or damage to property may be cuased, and whether or not the samemay have been caused or may be alleged to have been caused by negligence of the aforementioned parties or any of their employees or agents, or any other persons.

INSTRUCTIONS

#  A dog must be entered in the name of the person who actually owned it at the time entries for a trial 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 trial 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 A.K.C. [For complete rule, refer to Chapter 14, Section 3 of the "AKC Rules Applying to Registrations and Dog Shows".]