ONLINE Entry Form

k9Crazy Play Skool

June 14/15 2008, Stone Ridge, NY

Entries close Monday, May 19th, 2008 at 10 p.m.

Owner/Handler Information

Name:

Address:

City:

State:

Zip:

Phone:

Alt: Phone:

Email:

Dog Information

Reg. Name: APDT Reg#:

Call Name: Height at Withers: Jump Height

Date of Birth: Breed:

Check Titles Held: Level1 Level 2 Level 3

Handler's Name: (MUST be member of immediate family)

Entries accepted on a first-come-first served basis. Confirmations will be sent out after entries have closed.

Trial Entry and Fee Information

Using Food: Yes No

Will you be filing an exercise modification for this dog/handler? Yes No

Mail Check (Number of Rounds Selected x $22) PayPal (Number of Rounds Selected x $24)

Entry Fee Total

VERY IMPORTANT

We NEED Volunteers to help things run smoothly!

Sign me up as a trial volunteer!! Lunch provided for volunteers.

I have special diet needs, explain

Please let us know if you may be earning a NEW title at our trial.

We may earn our ...

RL1

RL2

RL3

RL1X

RL2X

RL3X

ARCH

ARCHX

ARCHEX

I, Full Name , have READ and ACCEPT

the terms of the General Agreement .

A confirmation form will show on your screen after you hit submit.

Please PRINT form and mail with check to

k9Crazy Rally O, 15 Goat Hill Rd, Saugerties, NY 12477

Confirmations will be sent after close of trial.