Dog Agility Trial Entry Form

Owner's Name

First Name

Last Name

Owner's Phone

Email

Address (to ensure we have up to date details, please provide your current mailing address)

Street Address

City

State / Province

ZIP / Postal Code

Emergency Contact Person Name

First Name

Last Name

Emergency Contact Phone

Dog (1) Call Name

NADAC Number - Dog (1)

Breed - Dog (1)

Date of Birth - Dog (1)

Height at Shoulder in Inches - Dog (1)

Jump Height - Dog (1)

Breed Height Exemption - Dog (1)

Yes No

What Category are You Entering - Dog (1)

Regular Veteran Junior Handler

Dog's Division - Dog (1)

Novice Open Elite

Would you like Ribbons or Dog Treats, should you Qualify or Place with this dog

Ribbons Dog Treats

Is the Handler the same person for all dogs? When yes is selected, the handler details will be hidden for all remaining dogs entered.

Yes No

Handler's Name

First Name

Last Name

Handler Division

Novice Open Elite

Dog (2) Call Name

NADAC Number - Dog (2)

Breed - Dog (2)

Date of Birth - Dog (2)

Height at Shoulder in Inches - Dog (2)

Jump Height - Dog (2)

Breed Height Exemption - Dog (2)

Yes No

What Category are You Entering - Dog (2)

Regular Veteran Junior Handler

Dog's Division - Dog (2)

Novice Open Elite

Would you like Ribbons or Dog Treats, should you Qualify or Place with this dog

Ribbons Dog Treats

Handler's Name

First Name

Last Name

Handler Division

Novice Open Elite

Dog (3) Call Name

NADAC Number - Dog (3)

Breed - Dog (3)

Date of Birth - Dog (3)

Height at Shoulder in Inches - Dog (3)

Jump Height - Dog (3)

Breed Height Exemption - Dog (3)

Yes No

What Category are You Entering - Dog (3)

Regular Veteran Junior Handler

Dog's Division - Dog (3)

Novice Open Elite

Would you like Ribbons or Dog Treats, should you Qualify or Place with this dog

Ribbons Dog Treats

Handler's Name

First Name

Last Name

Handler Division

Novice Open Elite

Dog (4) Call Name

NADAC Number - Dog (4)

Breed - Dog (4)

Date of Birth - Dog (4)

Height at Shoulder in Inches - Dog (4)

Jump Height - Dog (4)

Breed Height Exemption - Dog (4)

Yes No

What Category are You Entering - Dog (4)

Regular Veteran Junior Handler

Dog's Division - Dog (4)

Novice Open Elite

Would you like Ribbons or Dog Treats, should you Qualify or Place with this dog

Ribbons Dog Treats

Handler's Name

First Name

Last Name

Handler Division

Novice Open Elite

Dog (5) Call Name

NADAC Number - Dog (5)

Breed - Dog (5)

Date of Birth - Dog (5)

Height at Shoulder in Inches - Dog (5)

Jump Height - Dog (5)

Breed Height Exemption - Dog (5)

Yes No

What Category are You Entering - Dog (5)

Regular Veteran Junior Handler

Dog's Division - Dog (5)

Novice Open Elite

Would you like Ribbons or Dog Treats, should you Qualify or Place with this dog

Ribbons Dog Treats

Handler's Name

First Name

Last Name

Handler Division

Novice Open Elite

Dog (6) Call Name

NADAC Number - Dog (6)

Breed - Dog (6)

Date of Birth - Dog (6)

Height at Shoulder in Inches - Dog (6)

Jump Height - Dog (6)

Breed Height Exemption - Dog (6)

Yes No

What Category are You Entering - Dog (6)

Regular Veteran Junior Handler

Dog's Division - Dog (6)

Novice Open Elite

Would you like Ribbons or Dog Treats, should you Qualify or Place with this dog

Ribbons Dog Treats

Handler's Name

First Name

Last Name

Handler Division

Novice Open Elite

This option is only available for handlers with multiple dogs at double run format trials; where multiple dogs are entered in the same level of a course. You must decide at the time of entry, as options cannot be changed after entry submission.

Run in the first available slot

Please indicate which dog you prefer to run first if you have more than one dog entered into the same level and same class

Total No of Runs Entered for this Dog (1)

Total No of Runs Entered for this Dog (2)

Total No of Runs Entered for this Dog (3)

Total No of Runs Entered for this Dog (4)

Total No of Runs Entered for this Dog (5)

Total No of Runs Entered for this Dog (6)

Total No of Runs Entered for all Dogs

Total Fees to be Paid for all Dogs Entered

Terms and Conditions

Entry Confirmation

Please sign to agree to the terms as listed above

Sign here

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Dog Agility Trial Entry Form

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