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Official Canadian Kennel Club
Entry Form |
EPS TRAINING ASSOC.
Sept 29-30/18
ENTRIES CLOSE Sept 15/18.
Mail entries to: Ivan Paul, RR 4, Powassan, Ont., P0H 1Z0.
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Entry Fee:$_____________ Listing Fee:$___________
| [___]TD, Sat.$100.00 |
[___]TDX, Sat.$150.00 |
[___]UTD, Sat.(space permitting),$100.00 |
| [___]UTDX,Sat,(space permitting),$150.00 |
[___]UTD, Sunday, $100.00 |
[___]UDX, Sunday, $150.00 |
BREED |
REG. NAME OF
DOG
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Place of Birth
[___] Canada
[___]Elsewhere
Check one and Enter Number here:
[___]CKC Registration
Number |
Date of Birth |
Is this dog a
Tracking Ch?
[___]Yes
[___]No
Sex
____ |
| [___]CKC ERN Number |
[___]Day |
| [___]CKC Misc Cert. |
[___]Month |
| [___]Listed |
[___]Year | Breeder
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Reg'd Owner
Name:
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| Address: |
| City: |
Prov: |
Postal Code |
| Name of Owners Agent: |
| Agent's Address: |
| City: |
Prov: |
Postal Code |
| Mail I.D.
to: [ ______]Owner
or [_____]Agent (only 1 ID
mailed) |
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I Certify that I am the
registered owner(s) of the dog or that I am the authorized
agent of the owner(s) whose name(s) I have entered aboveand
accept full responsibility for all statements made in this
entry. In consideration of the acceptance of this enty, I (we)
agree to be bound by the rules and regulations of the Canadian
Kennel Club and by any additional rules and rugulations
appearing in the premium
list. |
Signature of Owner or Agent
Email address:
Telephone |
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