You still must fill out an official entry form,
sign it, and mail with appropriate entry fees to
 the Field Trial Secretary.
All entries and financial transactions need to be complete before the closing.

OFFICIAL AMERICAN KENNEL CLUB FIELD TRIAL or HUNT TEST ENTRY FORM
Club:
GEORGIA BRITTANY CLUB
Date:
12/7/2012-12/9/2012
Event Number:
2012093605 
Location: Good Hope Plantation Good Hope Circle, Naylor, GA Event Type:
FIELD TRIAL
Enter in Stake:

AKC No.

AKCLitter No. 

 ILP No
 Foreign No. Country I enclose entry fees
in the amount of   
Dog's Call Name:
Full Name of Dog:
Breed:
Reg. #
Sex:
Date of Birth:

FIELD DOG STUD BOOK #:

Sire:
Dam:
Name of Breeder:
Actual Owner(s):
Owner's Address
City: State: Zip:
Name of Owner's Agent / Handler: 

 

Agent's Address

City: State: Zip:

AKC Rules, Regulations, Policies and Guidelines are available on the
American Kennel Club website:www.akc.org
A G R E E M E N T
I certify that I am the actual owner of the dog, or that I am the duly authorized agent of the actual owner whose name I have entered above. In consideration of the acceptance of this entry, I (we) agree to abide by the rules and regulations of The American Kennel Club in effect at the time of this event, and any additional rules and regulations appearing in the premium list of this event and entry form and any decision made in accord with them. I (we) agree that the club holding this event has the right to refuse this entry for cause which the club shall deem sufficient. In consideration of the acceptance of this entry and of the holding of this event and of the opportunity to have the dog judged and to win prizes, ribbons, or trophies, I (we) agree to hold the AKC, the event-giving club, their members, directors, governors, officers, agents, superintendents or event secretary and the owner and/or lessor of the premises and any provider of services that are necessary to hold this event and any employees or volunteers of the aforementioned parties, and any AKC approved judge, judging at this event, 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 in or about the event premises or grounds or near any entrance thereto, and I (we) personally assume all responsibility and liability for any such claim; and I (we) further agree to hold the aforementioned parties harmless from any claim for loss, injury or damage to this dog. Additionally, I (we) hereby assume the sole responsibility for and agree to indemnify, defend and save the aforementioned parties harmless from any and all loss and expense (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 there from, 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, however such, injuries, death or property damage may be caused, and whether or not the same may have been caused or may be alleged to have been caused by the negligence of the aforementioned parties or any of their employees, agents, or any other persons.
I (WE) AGREE THAT ANY CAUSE OF ACTION, CONTROVERSY OR CLAIM ARISING OUT OF OR RELATED TO THE ENTRY, EXHIBITION OR ATTENDANCE AT THE EVENT BETWEEN THE AKC AND THE EVENT-GIVING CLUB (UNLESS OTHERWISE STATED IN TIS PREMIUM LIST) AND MYSELF (OURSELVES) OR AS TO THE CONSTRUCTION, INTERPRETATION AND EFFECT OF THIS AGREEMENT SHALL BE SETTLED BY ARBITRATION PURSUANT TO THE APPLICABLE RULES OF THE AMERICAN ARBITRATION ASSOCIATION. HOWEVER, PRIOR TO ARBITRATION ALL APPLICABLE AKC BYLAWS, RULES, REGULATIONS AND PROCEDURES MUST FIRST BE FOLLOWED AS SET FORTH IN THE AKC CHARTER AND BYLAWS, RULES, REGULATIONS, PUBLISHED POLICIES AND GUIDELINES.

SIGNATURE of Owner or His
Agent Duly Authorized to Make This Entry:
Telephone:
E-mail Address:

 



PRINT THIS FORM AFTER YOU HAVE FILLED IN THE BLANKS FOR YOUR RECORDS.

This form may or may not be an acceptable entry form by the AKC with the addition of a signature!

I have done everything in my power to make this as much like the official AKC form as possible.

You can download the official form HERE.

You still must fill out an official entry form, sign it, and mail with appropriate entry fees to the Field Trial Secretary. All entries and financial transactions need to be complete before the closing.

For more information contact:
Betty Morgan, Event Secretary
1397 Churchill Way
Marietta, GA 30062
(404) 429-3602