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Date Date Date

Dog must not be entered without a permanent UKC ® registration number or a UKC ® Temporary Listing number. Checkone of the two boxes below and enter your dog’s number. If your dog’s permanent registration is pending at UKC, andyou do not have a valid TL number, your entry will be invalid.

Dog’s UKC permanent reg. UKC TL UKC (PL/LP) # __________________________________

Breed of dog:__APBT____________________________ Variety (if applicable):___________ S ex:____

Dog’s Name: ____________________________________________________________________

C all Name: ______________________________________ Date of B irth: ____________________

J unior Name: ____________________________________J unior # : ________________________

Dog owner’s name(s): ____________________________________________________________

Address : ________________________________________________________________________

C ity: ____________________________________ S tate: ______________ ZIP ________________

Telephone (day):__________________________________ (eve): __________________________

E mail: __________________________________________________________________________

OFFICIAL UNITED KENNEL CLUB CONFORMATION ENTRY FORM

04-07-2019

40,00 euro

Signature of Owner/Handler Date

I have read and agree to the waiver on this form. I swear that this dog is not being handled by aprofessional handler in Conformation.

Entry Fee:

FO136FB L/R ev. 10-18

C onformation ( O nly C hoos e O ne ) Puppy (6 months-under 1 year) J unior (1 year-under 2 years) Adult (2 years & over) Open (6 months & over) Breeder & Handler (6 months & over shown bybreeder)

C hampion (C H) Grand C hampion (GR C H)

Non-Licensed C lass : _________________________

Altered C onformation (Only C hoos e One) Puppy (6 months-under 1 year) J unior (1 year-under 2 years) Adult (2 years & over) Open (6 months & over) Breeder & Handler (6 months & over shown bybreeder)

C hampion (C H) Grand C hampion (GR C H)

P l e a s e c h e c k t h e b o x f o r t h e a p p r o p r i a t e c l a s s .

IM P O R TA T IN F O R M ATIO N AB O U T TH IS E N TR Y F O R M : 1. All entries must be submitted on the current “Official UKC ® E ntry Form”. You may use one entry form

to enter the same dog in more than one show on the same weekend. 2. Use a separate entry form for each dog entered in a club's event.3. Mail all completed entry forms to the E vent S ecretary listed under the event, unless otherwise

specified. Make checks payable to host club.4. We want you to k eep the points earned at UK C L icens ed events . Important things to remember: • Dog not UKC registered? Apply for a Temporary Listing Number (TL) online at www.ukcdogs.com/tl-numbers.

(TL fees are non-refundable, non-transferable and do not apply to the cost of permanent registration.)• A ll dogs e nte r ing UK C e ve nts mus t be pe r ma ne ntly r e gis te r e d, ha ve a va lid

Te mpora r y L is ting N umbe r, or a P e r for ma nc e L is ting/L imite d P r ivile ge numbe r.• All entry forms must be completed and signed. Incorrect information submitted on the entry form may

invalidate your wins. • To be eligible to enter into the Breeder/Handler class, you must be one of the breeders of record, or

a member of the immediate family of one of the breeders of record. Immediate family includes:spouse, parent, step-parent, child, step-child, sibling, grandchild, or in-law, so long as the handler isnot a professional handler as defined by UKC Rules and Regulations.

5. The United Kennel C lub complies with the Americans with Disabilities Act. If you require anaccommodation, please contact the E vent C hair or S ecretary for this club’s event.

All events are held under the Official Rules and Regulations of the United Kennel C lub. Absolutely noalcoholic beverages, illegal drugs or firearms will be allowed on the grounds or in the buildings on theday of a UKC Licensed event. UKC , its agents and employees, and the host club assume no responsi-bility for any loss, damage, or injury sustained by spectators or by exhibitors and handlers , or to any oftheir dogs or property, and further assume no responsibility for injury to children not under the control oftheir 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 indem-nify and hold UKC, the host club and any approved UKC Judge harmless from any claims, actions or law-suits resulting from my participation in this event, and any action, decision or judgment made by any UKCor host club representative or approved Judge under the official UKC Rules and Regulations governingthis event. I acknowledge that the current Official UKC Rules and Regulations (Agility, Conformation,DockJumping, Drag Race, Junior Showmanship, Lure Coursing, Obedience, Rally Obedience, Weight Pull)have been made available to me, and that I am familiar with their contents. My signature indicates that Iunderstand and agree to the above and to abide by all of the current Official UKC Rules and Regulations.

Please print or type all information. Do not complete this form until you have read and signed the waiver.Invalid without signature.

WAIV E R

FOR C LUB US E ONLY

Armband: __________________________

Dog weight: ________________________

H O S T C L UB ACCP Europe__________________________________

I f owner is a minor/Signature of Parent or Guardian Date

J unior S howmans hipC las s es

Pee Wee (2 years-under 4 years) S ub J R (4 years-under 6 years) Pre-J unior (6 years-under 8 years) Novice J unior (8 years-under 13 years) Open J unior (8 years-under 13 years) Novice S enior (13 years-18 years) Open S enior (13 years-18 years)

Total Dog/Total J unior Total Dog Total J unior Participant

(if applicable)

X