O.G. BIERSTADT SCHUTZHUND CLUB TRIAL ENTRY

NAME OF DOG:_________________________________________________________

NAME OF HANDLER:____________________________________________________

ADDRESS:______________________________________________________________

PHONE:________________________________________________________________

EMAIL ADDRESS:_______________________________________________________

NAME AND ADDRESS OF OWNER (if different from handler)___________________

________________________________________________________________________

SEX:_____________BREED:____________________TITLE ENTERED FOR:_______

PRESENT TITLE:_______________DATE AWARDED:_________________________

SCOREBOOK#:_________________REGISTRATION#:_________________________

DATE OF BIRTH:_______________TATTOO#:________________________________

ENTRY FEES: $55.00 SchH or IPO I, II, III, $45 BH, AD

STEAK FRY ON SATURDAY NIGHT $20.00 – Includes meal and refreshments.

FEE MUST ACCOMPANY ENTRY, SCOREBOOK IS REQUIRED. MAKE ALL CHECKS PAYABLE TO O.G. BIERSTADT SCHUTZHUND CLUB.

RETURN ENTRY FORM TO, OR FOR MORE INFORMATION CONTACT:

Dorothy Esselmann

W2668 Scenic Drive

Campbellsport WI 53010

920-533-8583

Email – desselman@hotmail.com

The undersigned agrees to be fully responsible for the actions of his/her dog and to keep his/her dog under control at all times. H/she also agrees to remain on the grounds with his/her dog under control at all times. All participants must agree to conduct themselves in a sportsmanshiplike manner at all times during the trial. Only dogs entered in the trial will be allowed on the grounds. No dog will be allowed to compete without a USA scorebook or your SV scorebook stamped by the USA office.

Signed ____________________________________________________Date__________