ONLINE Entry Form

k9Crazy Play Skool

October 13, 2007, Stone Ridge, NY

Entries close Monday, October 1st, 2007 at 10 p.m.

Owner/Handler Information

Name:

Address:

City:

State:

Zip:

Phone:

Alt: Phone:

Email:

Dog Information

Reg. Name: CDSP Reg#:

Your dog MUST be registered with St. Hubert's prior to your entry.

Call Name: Height at Withers: Jump Height

Date of Birth: Breed:

Check Titles Held: Novice Open Utility

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

Will the modification affect this dog's jump height? Yes No

What height will be used?

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

Veteran Dog - 8 yrs or older

Therapy Dog - Registered

Mixed Breed/Rescue/Shelter Dog

Junior Handler - 16 yrs or younger

Handicapped Dog

Senior Handler - 65 yrs or older

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 Trials, 15 Goat Hill Rd, Saugerties, NY 12477

Confirmations will be sent after close of trial.