November 16-18 2018 Trial Entry Form - Judge: Peter Rohde

Dog's Registered Name: Titles:
Breed: Sex:
Date of Birth: Tattoo/Microchip:
Dog's UScA Reg#: HOT (Handler-owner-trained): Yes  No
Other Registry Name (AKC, SV, LOSH...): Other Registration #:
Scorebook Issuer: Scorebook #:

Handler: Handler Phone #:
Handler Membership Org.(USA, VDH, FCI or other AWDF...): Handler Membership #:
Handler Membership Expiry Date:
Street Address: Email:
City: State:

Owner Information if different from above:
Owner: Owner Phone #:
Owner Membership Org.(USA, VDH, FCI or other AWDF...): Owner Membership #:
Owner Membership Expiry Date:
Owner Street Address: Owner Email:
Owner City: Owner State:
Owner Zip:

Titles Entered for:
BH: AD: FH: FH2:  
IPO1: IPO2: IPO3:      
APr1: APr2: APr3: APr titles include obedience and protection like the old SchHA
FPr1: FPr2: FPr3: FPr titles are for tracking like the old TR1-3
UPr1: UPr2: UPr3: UPr titles are for obedience like the old OB1-3

Read the following statements carefully:

It is hereby understood that every dog at this trial will be under the direct care and control of its handler. The undersigned agrees to be fully responsible for any and all actions of his/her dog, including dogs owned by another but in the undersigned's care and to hold harmless all members, officers and directors of DFW Working Dogs and the  United Schutzhund Clubs of America, and any property owners  associated with this event in case of accident or injury. Any and all protests will be submitted in writing to the Trial Secretary at the event only. No protests will  be heard after the closing ceremonies. All decisions concerning any protests will be made by the time of the closing ceremony, and will be final. By typing my name in the box below, I hereby assume all responsibilities and liabilities for myself and my dogs and agree to abide by all USA guidelines and rules. My typed name shall act as a signature.
Name: Date:

Please send check to
Louise Jollyman, 982 Canterbury Lane, Forney, TX 75126
or pay by paypal on the next page.

Entry fees: $100