SWDC
(WDA)
TRIAL ENTRY FORM
Trial Date: Saturday, Dec 12th, with FH only on Sunday Dec 13, 2009
Trial Hours 8:00am – 5pm Entry Deadline: Dec
7, 2009
GSDCA-WDA JUDGE: Joe Tacket Helpers: C. Webber and/or A. Ayala
OFFERED: BH – OB 1-3 – TR 1-3 – SCH A – SCH 1-3
- IPO 1-3 (with FH (on Sunday)
Location: SWDC training grounds @ Lake Simonds
Park Tracking: grass/natural
terrain
Dog’s
Registered Name:
___________________________________________________________________________________________________
Breed:______________________________ Class you are entering
in:________________________________________________________________
SV,
AKC or FCI recognized Registration #:
____________________________________________________
(Note: USCA registration
numbers are not acceptable)
Sex:
_________ Tattoo #:_______________________ Scorebook #: _____________ Current
Titles: ________________________________________
Sire:________________________________________________________________________________________
Dam:_______________________________________________________________________________________
Owner
Name: _____________________________________________________________________________________________
WDA
Membership #: ___________
Address:
________________________________________________________________________________________________________________
Phone:
__________________________________________ Email:
__________________________________________________________________
Handler
Name:
____________________________________________________________________________________________
WDA
Member #: _______________
Address:
______________________________________________________________________________________________________________
Phone:
__________________________________________ Email:
________________________________________________________________
Please
enter my dog in the following classes:
Total amount enclosed $____________
BH $75 SchHA $75 SchH1/IPO $75 SchH2/IPO $75 SchH3/IPO $75 OB1-3 $75 TR 1-3 $75 FH $75
Junior Handler entry
fee: $25 (all classes)
Electric shock collars are
strictly forbidden at all GSDCA-WDA events and on all GSDCA-WDA event grounds
RELEASE
STATEMENT. It is understood that every
dog at this event will at all times be in the care and control of the dog’s
owner or handler. It is further
understood that the undersigned agrees to be fully responsible for the actions
of his/her dog(s) while on the event grounds.
I agree to hold HARMLESS the event-giving club, the German Shepherd Dog
Club of America, the German Shepherd Dog Club of America-Working Dog
Association, as well as their members and officers and directors and all
property owners for the loss or injury which may have allegedly been caused
directly or indirectly to any person or thing by any act of my dog while on the
event premises. I hereby assume all
responsibility and liability for such claims.
I further relinquish all claims and agree to hold HARMLESS the
event-giving club, the German Shepherd dog Club of America, the German Shepherd
Dog Club of America-Working Dog Association, their members, officers and
directors and all property owners for loss and/or injury which may have
allegedly been caused directly or indirectly to myself or my dog during
participation in this event.
WAIVER OF LIABIITY.
I
indemnify and hold harmless the German Shepherd Dog Club of America-Working Dog
Association, Inc. and the German Shepherd Dog Club of America, Inc., their
members, board of directors, officers, agents, employees, instructors, and
staff members from any and all claims, demands, actions, causes of action or
liability of any kind whatsoever, for death, bodily injury or property damage
caused in whole or in part by our acts, omissions and/or negligence, the acts,
omissions and/or negligence of any of our agents, servants, employees or
assigns, or brought onto the premises by us, our agents, servants, employees or
assigns.
The right of indemnification granted above, will
exist irrespective of whether the acts, omissions and/or negligence of the
German Shepherd Dog Club of America-Working Dog Association, Inc. and/or the
German Shepherd Dog Club of America, Inc. or the acts, omissions and or
negligence of any third person or party, also contributed to the loss and will
exist as set forth above in all circumstances except where the loss was caused
solely as a result of the negligence of the German Shepherd Dog Club of
America-Working Dog Association, Inc. and/or the German Shepherd Dog Club of
America, Inc.
I
have read and understand and agree to the foregoing RELEASE STATEMENT and WAIVER
OF LIABILITY
Signature:
___________________________________________ Printed name:
________________________________________ Date:__________________________
INCOMPLETE ENTRIES, ENTRIES THAT ARE NOT SIGNED, AND
ENTRIES WITHOUT PROPER DOCUMENTATION
WILL NOT BE ACCEPTED
FMI: ((903)) 356-4789
Mail
completed entries, fees, and copies of the required documents to:
SWDC, PO BOX 607, MIDLOTHIAN, TX
76065
Entries
that are not received on or before the event deadline dates will not be
accepted.