ENTRY APPLICATION

Only I Dog Per Entry Form.

Make Check Payable to Treasurer, WCTDTC in USD OR you can enter online by clicking here.

Name of Dog:			Current Titles/Ratings:
Date of Birth		Tattoo #		Sex
Registration number			Registry Organization AKC SV Other (circle one)
Sire			.Dam
Breeder			Address
Name of Registered Owner(s)			Address
Phone Number			City	State	Zip
			Email Address
Event(s) entering:

 All Pedigree and Registry Documents must be issued by an AKC and FCI Recognized Breed Registry.

Documents issued by pedigree services, breeders and/or non-AKC/FCI Organizations cannot be accepted.

Name of Authorized Handler: ______________________________________________________

For and in consideration of the Wesley Chapel Total Dog Training Club (hereinafter referred to as the “club”) acceptance of this application, I affirm that the foregoing information is true and correct. I hereby accept full and sole responsibility for the actions of; my dog, handler, family, any and all guest and myself who may attend the events of the club. Furthermore, I will forever hold harmless and defend the club from any claims whether real of alleged that may result from the actions of myself, my dog, handler, family or guest while attending or traveling to and from the events of the club with the understanding that my agreement to defend the club shall include any and all costs or expenses incurred by the club in its defense including but not limited to reasonable attorney fees whether said claims are real or alleged. In like manner, I shall forever defend and hold the club harmless for any injury whether real or alleged that may occur to me, my property, dog, family, handler or guest while attending or traveling to and from any event of the club. I understand and intend the term “club” used herein to mean and include, the club, its officers, directors, members, the event officials and volunteers secured by the club to host its events. I further acknowledge that my use of a handler constitutes my appointment of said handler as my “power of attorney” and I authorize said “power of attorney” to act for me and in my behalf in all matters relating to the dub and its events. The actions of the “power of attorney” shall be legal and binding upon me and construed as if I were acting for myself. I have read, fully understand and agree with the foregoing.

Signed: _______________________________________________________________Date: ________________________________________