CGC TEST (ONE DOG PER FORM) NAME* First Last ADDRESS* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PHONE (primary)*PHONE (secondary)EMAIL* DOG'S CALL NAME* DOGS DATE OF BIRTH* DOG'S BREED* I (we) agree to hold the AKC, the Waukesha Kennel Club, their members, directors, officers, 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, 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 harmless from any and all loss and expense (including legal fees) by reason of the liability imposed by law upon any of 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 (our) 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 persons.CGC TEST* Price: NON MEMBERS PRICEDATES November 2nd 2022 November 9th 2022 November 16th 2022 FOR YOUR SECURITY, WHEN YOU CLICK ON THE SUBMIT BUTTON YOU WILL LEAVE THE WKC SITE AND BE TAKEN TO A SECURE PAY PAL SITE TO MAKE YOUR PAYMENT. IF YOU ALREADY HAVE A PAY PAL ACCOUNT YOU MUST LOG INTO THAT ACCOUNT TO PAY OR A SECURITY ERROR WILL OCCUR. IF YOU DO NOT HAVE A PAY PAL ACCOUNT YOU MAY PAY AS A GUEST USER. A CONFIRMATION OF YOUR PAYMENT WILL BE EMAILED TO THE EMAIL ADDRESS YOU PROVIDED T.O PAY PAL.Total $0.00 * I agree to the terms above
