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O1 O2 O3 O4 R1 R2 R3 R4 $ Total
Entry Fee (prior to closing) $25
Entry Fee (day of trial) $27Listing Fee 9.50
Exhibition Only 5.00
Catalogue Qty ___ @ $6 Total Fees Enclosed $
Registered Name of Dog:
Check one & enter number here:
CKC Reg. No____________________
CKC ERN No____________________
Listed
CKC Misc.______________________
Date of Birth
D_____M_____Y_____
Place of Birth
Canada
Elsewhere
Jump Height
___________
Broad Jump
__________
Breeder(s)
Sire
Dam
Regd Owner(s)Owners Address
City Prov PC
Owners Agent (if any) at show
Agents Address
City Prov PC
Breeder(s)
Sire
Dam
Regd Owner(s)Owners Address
City Prov PC
Owners Agent (if any) at show
Agents Address
City Prov PC
Registered Name of Dog:
Check one & enter number here:
CKC Reg. No____________________
CKC ERN No____________________
Listed
CKC Misc.______________________
Date of Birth
D_____M_____Y_____
Place of Birth
Canada
Elsewhere
Jump Height
___________
Broad Jump
__________
O1 O2 O3 O4 R1 R2 R3 R4 $ Total
Entry Fee $25
Entry Fee (day of trial) $27Listing Fee 9.50
Exhibition Only 5.00
Catalogue Qty ___ @ $6 Total Fees Enclosed $
Official Canadian Kennel Club Entry Form
River Valley Obedience & Field Trial Club
July 27, 28 2013
Sex: Variety:Breed:
Novice A Utility A Novice C Rally Advanced A
Novice B Utility B Exhibition Rally Advanced B
Open A Pre-Novice Rally Nov. A Rally Excellent A
Open B Novice-Intermediate Rally Nov. B Rally Excellent B
Mail ID to: Owner Agent I certify that I am the registered owner(s) of the dog orthat I am the authorized agent of the actual owner(s) whose name(s) I have entered above and
accept full responsibility for all statements made in t his entry. In consideration of the
acceptance of this entry, I (we) agree to be bound by the rules and regulations of the Canadian
Kennel Club and by any additional rules & regulations appearing in the Premium List.
________________________ E-Mail____________________________________________
Signature of Owner or Agent
Telephone____________________________________
Official Canadian Kennel Club Entry Form
River Valley Obedience & Field Trial Club
July 27, 28 2013
Breed:Variety: Sex:
Novice A Utility A Novice C Rally Advanced A
Novice B Utility B Exhibition Rally Advanced B
Open A Pre-Novice Rally Nov. A Rally Excellent A
Open B Novice-Intermediate Rally Nov. B Rally Excellent B
Mail ID to: Owner Agent I certify that I am the registered owner(s) of the dog orthat I am the authorized agent of the actual owner(s) whose name(s) I have entered above and
accept full responsibility for all statements made in t his entry. In consideration of the
acceptance of this entry, I (we) agree to be bound by the rules and regulations of the Canadian
Kennel Club and by any additional rules & regulations appearing in the Premium List.
________________________ E-Mail____________________________________________
Signature of Owner or Agent
Telephone____________________________________
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