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Kenai Schutzhund Club

Judge: Jim Elder                   Date:               June 27-29, 2003

Please Circle Desired Titles (Pay By June 20, 2003):


BH                                          $40          SCH I, II, III                           $65                                         

FH                                           $50          IPO I, II, III

AD                                          $40

OB I, II, III                             $40          TRACK I , II, III                    $40


Participant Information:

Name:                     _______________________________________

Address:                _______________________________________


Phone Number:     _______________________________________

USA Member #:   _______________________________________



Registration Name _________________________________

Breed: ___________   DOB _____________ Sex: ________

Call Name _______________________________________

Registration # _______________ Score Book # ___________


Registration Name ________________________________

Breed: ___________   DOB ____________ Sex: ________

Call Name ______________________________________

Registration # ______________ Score Book # ___________



Agreement & Understanding of Liability

1)       I understand and agree that my participation in Kenai Schutzhund Club activities is at my own risk.

2)       I understand that I am responsible for the actions of my dog(s) and/or any dog(s) in my possession and I agree to keep my dog(s) and/or any dog(s) in my possession properly restrained and under control at all times.

3)       I agree to hold Kenai Schutzhund Club, United Schutzhund Clubs of America, it's officers, directors, and members, as well as any ground or property owners, absolutely harmless for loss or injury which may have allegedly been caused directly or indirectly to any person, any dog, or any thing, and by any act of my dog(s) and /or any dog(s) in my possession while on the training/trial/test/seminar grounds. Furthermore, I agree to personally assume all responsibility and liability for such claim.

4)       I understand that it my responsibility to provide ample insurance to cover the possible actions of my dog (s) and/or any dog (s) in my possession

5)       All dogs in training shall be current with their vaccinations for Rabies, DIR., and Parvo. Proof of vaccinations must be submitted upon request from the Board of Directors

6)       I agree that the training of my dog (s) and /or any dog (s) in my possession is primarily for the purpose of the sport of Schutzhund. Furthermore, I understand that owning a dog that is being trained in the sport of Schutzhund is a greater responsibility than average pet ownership

7)       I agree to abide by the constitution and by-laws of the Kenai Schutzhund Club, a copy of which will be provided for me upon request

8)       No refunds for fees paid shall be allowed


Signature of Participant:                                                                                                                                Date:

Mail Entry form to:  Kelly Blackston;PO Box 670953; Chugiak, AK 99567           Questions?