I certify that I am the actual owner of the dog, or that I am the duly authorized agent of the actual owner of the dog entered hereon. In consideration of the acceptance of this entry, I/we ("I") have read, and understand, and will abide by the Official Rules and Regulations of the Agility Association of Canada (AAC) in effect at the time of this entry, and by any additional rules and regulations appearing in the Agility Schedule for this event. I 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 General Agreement/Disclaimer. I agree to conduct myself (ourselves) in accordance with such Official Rules and Regulations (including provisions applying to discipline) and to abide by any decisions made with them.

I agree that the organization hosting this event (Wimberway Farms) has the right to refuse this entry for cause, which the organization shall deem to be sufficient. In consideration of acceptance of this entry and the hosting of this event, and of the opportunity to have the dog participate or be judged, I agree to hold the organization, its members, officers, and directors, the Agility Association of Canada, (AAC), and its officers and directors, sponsors of the event, owners of the premises upon which the event is held, ands their employees, harmless from any claim for loss or injury which may be alleged to have been caused directly or indirectly to any person or thing by the act of this dog while on the premises or grounds or near any entrance thereto, and I personally assume all responsibility and liability for any such claim, and I further agree to hold the aforementioned parties harmless from any claim for loss of this dog by disappearance, theft, death, or otherwise, and from any claim for damage or injury ne caused, or allege to be caused by the negligence of the parties aforementioned, or by negligence of any other person, or any other cause or causes. I assume the sole responsibility for, and agree to indemnify and save the aforementioned parties harmless from any and all loss and expenses (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 therefore, 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 event, howsoever such injuries, death, or damage may be caused, and whether or not the same may have been caused or may have been alleged to have been caused by negligence of the aforementioned parties, their employees or agent, or any other person.

The personal information collected herein is for the purpose of enabling you to participate in our trial as a competitor. The personal information you have provided will be used by Wimberway Farms to administer this event in accordance with the AAC rules governing the hosting of an agility trial. The personal information will be disclosed, in accordance with the AAC rule book for post trial reporting obligations. By signing below, you consent to the collection, use, and disclosure of your personal information as described herein.

I have read, understand, acknowledge, and agree to abide by the above Agreement and understand that I am fully responsible for the behaviour of my dog(s) attending this event whether entered or not.

Print name: __________________________________________________________

Signature:__________________________________________________________

Signature of parent/legal guardian of minor: ______________________________

Date: