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Official Canadian Kennel Club
Entry Form |
EPS TRAINING ASSOC.
Sept 26-27/20
Entries Open Sept 1, and CLOSE Sept 15/20.
Mail entries to: Ivan Paul, RR 4, Powassan, Ont., P0H 1Z0.
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Entry Fee:$_____________ Listing Fee:$___________
[___]TD, Saturday, $100.00 ------ .
[___]TDX, Saturday, $150.00 |
[___]UTD, Saturday, $100.00 ----- [___] UTDX Saturday, $150 | [___]TD, Sunday, $100 ,------------ [___] TDX, Sunday, $150.00 | [___]UTD, Sunday, $100.00-------[__]UTDX Sunday, $150 | 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 |
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 regulations
appearing in the premium list. |
Signature of Owner or Agent
Email address: Telephone |
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