OFFICIAL UNITED KENNEL CLUB, INC.
Entry Form
EM #1001
MAUDE TANK
RICHMOND KY SHOWS
FEBRUARY 24, 25 & 26, 2012
MADISON CO. Fair Grounds
6 MULTI-BREED SHOWS
Dead line For Pre entry: February 18, 2012
One form may be used for multiple-day entries of the same dog. Check the appropriate box next to the class that you are entering your dog for each day the dog will be exhibited. Completely fill in all information pertaining to the dog that you are entering.
$20.00 PRE ENTRY- $25.00 DAY OF SHOW
JUNIOR SHOWMANSHIP $10.00
NOVICE PUPPY $5.00
SPECIAL: ALL 6 SHOWS. $100.00 (By Feb. 18, 2012)
*** Required fields.
Breed of Dog ***.
Variety of Dog
Dog may not be entered without a permanent UKC registration number,
A UKC Temporary Listing (TL) number or a UKC Limited Privilege (LP) number.
Choose one of the three types of registration below and entry your dog's number.
If your dog's permanent registration is pending at UKC, and you do not have a valid TL number, your entry will be invalid.
TL numbers will be available at the show site
Registered As ? ***
U.K.C. Registration/Listing Number ***
Date of Birth (mm/dd/yyyy) ***
Name of Dog ***
Sex ***
Owner's name(s) ***
Address ***
City ***
Zip Code ***
Telephone:***
E-mail address .
Friday Feb. 24
Saturday Feb. 25
Sunday Feb. 26
JUNIOR SHOWMANSHIP
Both Classes- 8yrs but under 13 yrs
13yrs, under 18yrs
Name of Junior
Birth Date
UKC Juniors Number
WAIVER
All events are held under the Official Rules and Regulations of the United Kennel Club, Inc.
Absolutely no alcoholic beverages, gambling, illegal drugs or firearms will be allowed on the grounds
or in the buildings on the day of a UKC Licensed event. UKC, its agents and employees, and the host club assume no responsibility for any loss, damage, or injury sustained by spectators or by exhibitors and handlers, or to any of their dogs or property, and further assume no responsibility for injury to children not under the control of their parents or guardians. UKC and the host club are not responsible for loss, accidents or theft.
By signing this form, I hereby agree to waive any claim, action, or lawsuit and further agree to
indemnify and hold UKC, the host club and any approved UKC Judge harmless from any claims,
actions or lawsuits resulting from my participation in this event, and any action, decision or judgment
made by any UKC or host club representative or approved Judge under the official UKC Rules and
Regulations governing this event. I acknowledge that the current Official UKC Rules and Regulations
(Agility, Conformation, Dog Sport, Junior Showmanship, Obedience, Terrier Race, Weight Pull) have
been made available to me, and that I am familiar with their contents. My signature indicates that I understand and agree to the above and to abide by all of the current Official UKC Rules and Regulations here to add text.
Secure Online Payment
When you click the Submit button.
You will be taken to the Thank you page.
Follow step 2 to make Secure Online payment.
(on the left) click on the RICHMOND KY
A service charge of $3.50 will be added to your payment
for handling fee.
BREED CLASSES
$20.00 PRE ENTRY- $25.00 DAY OF SHOW
JUNIOR SHOWMANSHIP $10.00
NOVICE PUPPY $5.00
SPECIAL: ALL SIX SHOWS $100.00 (By Feb. 18, 2012)
