PURCHASE AREA HRC
Hunt Test Premium
May 5th & 6th
I submit $_____________ for entry fees. One entry form per dog, per day.
Enter in stake/test: Started______ Seasoned_______ Finished_______
Enter in Hunt Day: Saturday______ Sunday______
(PLEASE PRINT CLEARLY)
Registered Name of Dog:______________________________________
Call Name:________________ UKC Registration #:_________________
UKC Points:________(optional) BREED:________________________
Male:____ Female:____ Date of Birth: _______________
Sire:_____________________________________________________
Dam:_____________________________________________________
Breeder:__________________________________________________
Name of Registered Owner:___________________________________
Owner's HRC #____________ (optional) Home Club:_______________
Owners Address:___________________________________________
City:________________________ State:__________ ZIP:_________
Phone#:_____-_____-_________ EMAIL Address:________________
Name of Handler:___________________________________________
I certify that the above dog's communicable disease
Immunizations are current:
Owner Siganture:____________________________________
(registered Owner or His'Her Handler Duly Authorized to make this entry)
Handlers Address (if Handler signs Above Line for Registered Owner)
Address:_________________________________________________
City:______________________ State:________ ZIP:____________
Phone#:____-_____-________ EMAIL Address:_________________
HRC Membership Affiliation:______________________ optional
HRC Membership #_____________________________ optional
I agree NOT to hold the landowner(s) responsible for loss of property,
damage or injury incurred during this event. UKC and the host Club
are not responsible for loss, accident or theft. UKC and the host
Club assume no responsibility for any damage or injury sustained by
the exhibitors, 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 gaurdians.