OFFICIAL AMERICAN KENNEL CLUB FIELD TRIAL ENTRY FORM
Note: This Entry Form Must Be Completed in Full
Club: ESSFTA
Location:  Mt Sterling, Ohio
Date: November 15, 2018 to Conclusion Entries Close Sunday, October 28, 2018*

EVENT #2018 1664 27
 
 I SUBMIT $ 250.00  for entry fees.  
	
 Enter in Stake/Test:  Amateur   
NAME OF                                                                               	CALL
DOG (Print)      	NAME       
A.K.C. Reg       	Or A.K.C. Litter Number
Number          	(If Dog Not Reg.)       
Or Foreign Reg. No.      	And Country of Registry       
Breed ESS  MALE    FEMALE    Date of Birth     
Sire           
Dam          	
Breeder        
Name of Actual Owner (Print)       
Owner's Address       
City             	State       	Zip Code         
Name of Owners Agent/Handler (Print)        
Owner Phone:      	Owner Email:      						

Dogs earning their qualifying point in a trial held between November 4, 2017 and October 28, 2018 (inclusive) will be allowed to enter the trial ONLY if their entry is received via email, snail mail,  or through Hunt Secretary (https://www.huntsecretary.com/) no later than 10:00 PT on October 28, 2018.

*Dogs that qualify between October 28, 2018 (inclusive) and November 4, 2018 (inclusive) may enter if their completed entry is RECEIVED via email by the field trial secretary NAC@onlinenw.com or entered in Hunt Secretary (https://www.huntsecretary.com/) no later than 10:00pm PT on November 4, 2018. Entries for dogs that qualified prior to October 28, 2018 will not be accepted after the October 28, 2018 closing date.  

AKC Rules, Regulations, Policies and Guidelines are available on the American Kennel Club website at www.akc.org
AGREEMENT
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 therefrom, 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 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 Agent 
Duly Authorized to Make this Entry

Mail completed entry and fees to:
Jan Johnson
NAC Secretary
7225 Ridgeway Rd
Sheridan, OR 97378