Michigan Gazehound Association
AKC Rules, Regulations, Policies and Guidelines are available on the American Kennel Club website: www.akc.org
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Saturday June 29, 2019 AKC Lure Coursing Entry Form
Name of Actual Owner(s)
Breed
Call Name
Full Name of Dog
Sire
Dam
Breeder
Name of Owner's Agent/Handler (if any) at Trial
Name of Junior Handler (if any)
Junior Handler Number (if any)
AKC Registration
AKC Number
PAL/ILP Number
Foreign & List Country
AKC Number
Date of Birth
-
Month
-
Day
Year
Sex
Dog
Bitch
Stake
Open
Special
Veteran
If possible, please separate my entries.
Additional Hounds, Same Owner Address, Saturday
Enter Additional Hound 1, Same Owner Address, Saturday
Breed
Call Name
Full Name of Dog
Sire
Dam
Name of Owner's Agent/Handler (if any) at Trial
Name of Junior Handler (if any)
Junior Handler Number (if any)
AKC Registration
AKC Number
PAL/ILP Number
Foreign & List Country
AKC Number
Date of Birth
-
Month
-
Day
Year
Sex
Dog
Bitch
Stake
Open
Special
Veteran
If possible, please separate my entries.
Enter Additional Hound 2, Same Owner Address, Saturday
Name of Actual Owner(s)
Breed
Call Name
Full Name of Dog
Sire
Dam
Breeder
Name of Owner's Agent/Handler (if any) at Trial
Name of Junior Handler (if any)
Junior Handler Number (if any)
AKC Registration
AKC Number
PAL/ILP Number
Foreign & List Country
AKC Number
Date of Birth
-
Month
-
Day
Year
Sex
Dog
Bitch
Stake
Open
Special
Veteran
If possible, please separate my entries.
Enter Additional Hound 3, Same Owner Address, Saturday
Name of Actual Owner(s)
Breed
Call Name
Full Name of Dog
Sire
Dam
Breeder
Name of Owner's Agent/Handler (if any) at Trial
Name of Junior Handler (if any)
Junior Handler Number (if any)
AKC Registration
AKC Number
PAL/ILP Number
Foreign & List Country
AKC Number
Date of Birth
-
Month
-
Day
Year
Sex
Dog
Bitch
Stake
Open
Special
Veteran
If possible, please separate my entries.
Enter Additional Hound 4, Same Owner Address, Saturday
Name of Actual Owner(s)
Breed
Call Name
Full Name of Dog
Sire
Dam
Breeder
Name of Owner's Agent/Handler (if any) at Trial
Name of Junior Handler (if any)
Junior Handler Number (if any)
AKC Registration
AKC Number
PAL/ILP Number
Foreign & List Country
AKC Number
Date of Birth
-
Month
-
Day
Year
Sex
Dog
Bitch
Stake
Open
Special
Veteran
If possible, please separate my entries.
Enter Additional Hound 5, Same Owner Address, Saturday
Name of Actual Owner(s)
Breed
Call Name
Full Name of Dog
Sire
Dam
Breeder
Name of Owner's Agent/Handler (if any) at Trial
Name of Junior Handler (if any)
Junior Handler Number (if any)
AKC Registration
AKC Number
PAL/ILP Number
Foreign & List Country
AKC Number
Date of Birth
-
Month
-
Day
Year
Sex
Dog
Bitch
Stake
Open
Special
Veteran
If possible, please separate my entries.
Enter Additional Hound 6, Same Owner Address, Saturday
Name of Actual Owner(s)
Breed
Call Name
Full Name of Dog
Sire
Dam
Breeder
Name of Owner's Agent/Handler (if any) at Trial
Name of Junior Handler (if any)
Junior Handler Number (if any)
AKC Registration
AKC Number
PAL/ILP Number
Foreign & List Country
AKC Number
Date of Birth
-
Month
-
Day
Year
Sex
Dog
Bitch
Stake
Open
Special
Veteran
If possible, please separate my entries.
Enter Additional Hound 7, Same Owner Address, Saturday
Name of Actual Owner(s)
Breed
Call Name
Full Name of Dog
Sire
Dam
Breeder
Name of Owner's Agent/Handler (if any) at Trial
Name of Junior Handler (if any)
Junior Handler Number (if any)
AKC Registration
AKC Number
PAL/ILP Number
Foreign & List Country
AKC Number
Date of Birth
-
Month
-
Day
Year
Sex
Dog
Bitch
Stake
Open
Special
Veteran
If possible, please separate my entries.
Enter Additional Hound 8, Same Owner Address, Saturday
Name of Actual Owner(s)
Breed
Call Name
Full Name of Dog
Sire
Dam
Breeder
Name of Owner's Agent/Handler (if any) at Trial
Name of Junior Handler (if any)
Junior Handler Number (if any)
AKC Registration
AKC Number
PAL/ILP Number
Foreign & List Country
AKC Number
Date of Birth
-
Month
-
Day
Year
Sex
Dog
Bitch
Stake
Open
Special
Veteran
If possible, please separate my entries.
Enter Additional Hound 9, Same Owner Address, Saturday
Name of Actual Owner(s)
Breed
Call Name
Full Name of Dog
Sire
Dam
Breeder
Name of Owner's Agent/Handler (if any) at Trial
Name of Junior Handler (if any)
Junior Handler Number (if any)
AKC Registration
AKC Number
PAL/ILP Number
Foreign & List Country
AKC Number
Date of Birth
-
Month
-
Day
Year
Sex
Dog
Bitch
Stake
Open
Special
Veteran
If possible, please separate my entries
Enter Additional Hound 10, Same Owner Address, Saturday
Name of Actual Owner(s)
Breed
Call Name
Full Name of Dog
Sire
Dam
Breeder
Name of Owner's Agent/Handler (if any) at Trial
Name of Junior Handler (if any)
Junior Handler Number (if any)
AKC Registration
AKC Number
PAL/ILP Number
Foreign & List Country
AKC Number
Date of Birth
-
Month
-
Day
Year
Sex
Dog
Bitch
Stake
Open
Special
Veteran
If possible, please separate my entries.
Section End - Saturday
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Next
Sunday June 30, 2019 AKC Lure Coursing Entry Form
Name of Actual Owner(s)
Breed
Call Name
Full Name of Dog
Sire
Dam
Breeder
Name of Owner's Agent/Handler (if any) at Trial
Name of Junior Handler (if any)
Junior Handler Number (if any)
AKC Registration
AKC Number
PAL/ILP Number
Foreign & List Country
AKC Number
Date of Birth
-
Month
-
Day
Year
Sex
Dog
Bitch
Stake
Open
Special
Veteran
If possible, please separate my entries.
Additional Hounds, Same Owner Address, Sunday
Enter Additional Hound 1, Same Owner Address, Sunday
Name of Actual Owner(s)
Breed
Call Name
Full Name of Dog
Sire
Dam
Breeder
Name of Owner's Agent/Handler (if any) at Trial
Name of Junior Handler (if any)
Junior Handler Number (if any)
AKC Registration
AKC Number
PAL/ILP Number
Foreign & List Country
AKC Number
Date of Birth
-
Month
-
Day
Year
Sex
Dog
Bitch
Stake
Open
Special
Veteran
If possible, please separate my entries.
Enter Additional Hound 2, Same Owner Address, Sunday
Name of Actual Owner(s)
Breed
Call Name
Full Name of Dog
Sire
Dam
Breeder
Name of Owner's Agent/Handler (if any) at Trial
Name of Junior Handler (if any)
Junior Handler Number (if any)
AKC Registration
AKC Number
PAL/ILP Number
Foreign & List Country
AKC Number
Date of Birth
-
Month
-
Day
Year
Sex
Dog
Bitch
Stake
Open
Special
Veteran
If possible, please separate my entries.
Enter Additional Hound 3, Same Owner Address, Sunday
Name of Actual Owner(s)
Breed
Call Name
Full Name of Dog
Sire
Dam
Breeder
Name of Owner's Agent/Handler (if any) at Trial
Name of Junior Handler (if any)
Junior Handler Number (if any)
AKC Registration
AKC Number
PAL/ILP Number
Foreign & List Country
AKC Number
Date of Birth
-
Month
-
Day
Year
Sex
Dog
Bitch
Stake
Open
Special
Veteran
If possible, please separate my entries.
Enter Additional Hound 4, Same Owner Address, Sunday
Name of Actual Owner(s)
Breed
Call Name
Full Name of Dog
Sire
Dam
Breeder
Name of Owner's Agent/Handler (if any) at Trial
Name of Junior Handler (if any)
Junior Handler Number (if any)
AKC Registration
AKC Number
PAL/ILP Number
Foreign & List Country
AKC Number
Date of Birth
-
Month
-
Day
Year
Sex
Dog
Bitch
Stake
Open
Special
Veteran
If possible, please separate my entries.
Enter Additional Hound 5, Same Owner Address, Sunday
Name of Actual Owner(s)
Breed
Call Name
Full Name of Dog
Sire
Dam
Breeder
Name of Owner's Agent/Handler (if any) at Trial
Name of Junior Handler (if any)
Junior Handler Number (if any)
AKC Registration
AKC Number
PAL/ILP Number
Foreign & List Country
AKC Number
Date of Birth
-
Month
-
Day
Year
Sex
Dog
Bitch
Stake
Open
Special
Veteran
If possible, please separate my entries.
Enter Additional Hound 6, Same Owner Address, Sunday
Name of Actual Owner(s)
Breed
Call Name
Full Name of Dog
Sire
Dam
Breeder
Name of Owner's Agent/Handler (if any) at Trial
Name of Junior Handler (if any)
Junior Handler Number (if any)
AKC Registration
AKC Number
PAL/ILP Number
Foreign & List Country
AKC Number
Date of Birth
-
Month
-
Day
Year
Sex
Dog
Bitch
Stake
Open
Special
Veteran
If possible, please separate my entries.
Enter Additional Hound 7, Same Owner Address, Sunday
Name of Actual Owner(s)
Breed
Call Name
Full Name of Dog
Sire
Dam
Breeder
Name of Owner's Agent/Handler (if any) at Trial
Name of Junior Handler (if any)
Junior Handler Number (if any)
AKC Registration
AKC Number
PAL/ILP Number
Foreign & List Country
AKC Number
Date of Birth
-
Month
-
Day
Year
Sex
Dog
Bitch
Stake
Open
Special
Veteran
If possible, please separate my entries.
Enter Additional Hound 8, Same Owner Address, Sunday
Name of Actual Owner(s)
Breed
Call Name
Full Name of Dog
Sire
Dam
Breeder
Name of Owner's Agent/Handler (if any) at Trial
Name of Junior Handler (if any)
Junior Handler Number (if any)
AKC Registration
AKC Number
PAL/ILP Number
Foreign & List Country
AKC Number
Date of Birth
-
Month
-
Day
Year
Sex
Dog
Bitch
Stake
Open
Special
Veteran
If possible, please separate my entries.
Enter Additional Hound 9, Same Owner Address, Sunday
Name of Actual Owner(s)
Breed
Call Name
Full Name of Dog
Sire
Dam
Breeder
Name of Owner's Agent/Handler (if any) at Trial
Name of Junior Handler (if any)
Junior Handler Number (if any)
AKC Registration
AKC Number
PAL/ILP Number
Foreign & List Country
AKC Number
Date of Birth
-
Month
-
Day
Year
Sex
Dog
Bitch
Stake
Open
Special
Veteran
If possible, please separate my entries.
Enter Additional Hound 10, Same Owner Address, Sunday
Name of Actual Owner(s)
Breed
Call Name
Full Name of Dog
Sire
Dam
Breeder
Name of Owner's Agent/Handler (if any) at Trial
Name of Junior Handler (if any)
Junior Handler Number (if any)
AKC Registration
AKC Number
PAL/ILP Number
Foreign & List Country
AKC Number
Date of Birth
-
Month
-
Day
Year
Sex
Dog
Bitch
Stake
Open
Special
Veteran
If possible, please separate my entries.
Section End - Sunday
Back
Next
Agreement
I certify that I am the actual owner of the dog, or that I am the duly authorized agent of the actual owner whose name I have entered above. In consideration of the acceptance of this entry, I (we) agree to abide by the rules and regulations of The American Kennel Club in effect at the time of this event, and by any additional rules and regulations appearing in the premium list for this event and entry form and any decision made in accord with them. I (we) agree that the club holding this event has the right to refuse this entry for cause which the club shall deem to be sufficient. I (we) certify and represent that the dog entered is not a hazard to persons or other dogs. In consideration of the acceptance of this entry and of the holding of this event and of the opportunity to have the dog judged and to win prizes, ribbons, or trophies, I (we) agree to hold the AKC, the event-giving club, their members, directors, governors, officers, agents, superintendents or event secretary and the owner and/or lessor of the premises and any provider of services that are necessary to hold this event and any employees or volunteers of the aforementioned parties, and any AKC approved judge, judging at this event harmless from any claim for loss or injury which may be alleged to have been caused directly or indirectly to any person or thing by the act of this dog while in or about the event premises or grounds or near any entrance thereto, and I (we) personally assume all responsibility and liability for any such claim; and I (we) further agree to hold the aforementioned parties harmless from any claim for loss, injury or damage to this dog. Additionally, I (we) hereby assume the sole responsibility for and agree to indemnify, defend and save the aforementioned parties for damage because of bodily injuries, including death at any time resulting therefrom, sustained by any person or persons, including myself (ourselves), or on account of damage to property, arising out of or in consequence of my (out) participation in this event, however such, injuries, death or property damage may be caused, and whether or not the same may have been caused or may be alleged to have been caused by the negligence of the aforementioned parties or any of their employees, agents, or any other person. I (we) agree that the determination of whether the injury is serious shall be made by the event veterinarian and is binding on me (us). I (WE) AGREE THAT ANY CAUSE OF ACTION, CONTROVERSY OR CLAIM ARISING OUT OF OR RELATED TO THE ENTRY, EXHIBITION OR ATTENDANCE AT THE EVENT BETWEEN THE AKC AND THE EVENT-GIVING CLUB (UNLESS OTHERWISE STATED IN THE PREMIUM LIST) AND MYSELF (OURSELVES) OR AS TO THE CONSTRUCTION, INTERPRETATION AND EFFECT OF THIS AGREEMENT SHALL BE SETTLED BY ARBITRATION PURSUANT TO THE APPLICABLE RULES OF THE AMERICAN ARBITRATION ASSOCIATION. HOWEVER, PRIOR TO ARBITRATION ALL APPLICABLE AKC BYLAWS, RULES, REGULATIONS AND PROCEDURES MUST FIRST BE FOLLOWED AS SET FORTH IN THE AKC CHARTER AND BYLAWS, RULES, REGULATIONS, PUBLISHED POLICIES AND GUIDELINES.
Signature of owner or agent duly authorized to make these entries
*
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AKC Dogs, Same Handler
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