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Official Canadian Kennel Club
Entry Form |
EPS TRAINING ASSOC.
Sept 29/18
ENTRIES CLOSE Sept 19/18 or when limit is reached, whichever comes first.
Mail entries to: Ivan Paul, RR 4, Powassan, Ont., P0H 1Z0.
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[___] trial 1 [___] trial 2.
Entry Fee:$___________ Listing Fee:$___________
| [___]Pre Novice; [___]Novice A; [___]Nov.B; Novice C;[___] Nov. Int. |
[___]Open HA;[___] H18; [___]HB; [___]HB18
[___]Utility A [___]Utility B |
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 a
puppy?
[___]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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