AKC SANCTIONED 2021 B-OB MATCH ENTRY FORM OFFICIAL AKC ENTRY FORM FIELDS ARE ALL REPRESENTED WITHIN THIS ONLINE FORM. **NEW** IMPORTANT PAY ONLINE WITH PAY PAL INFORMATIONYOU DO NOT NEED A PAY PAL ACCOUNT TO PAY ON LINE .....This online form allows you to pay with PayPal your total is displayed at the end of the form. VERY IMPORTANT: if you already have a log in with PayPal your information will be recognized by the system and you will need to login to continue or an error will occur. Additionally every aspect of your your login information must EXACTLY match your your Pay Pal account information or you will experience difficulty paying online. When you click the submit button you will leave the WKC site and be taken to a secure pay pal site to complete your transaction. Confirmation of your payment will be emailed to you once your transaction is completed. If you register with pay pal (free) you are able to pay with a checking account or credit card. if you opt to use this service as a guest, credit card will be your only option. Read instructions at the bottom of this form carefully before filing out. Numbers in the boxes indicate sections of the Instructions relevant to the information needed in that box (PLEASE PRINT), NEXT, be sure to READ the agreement and SIGN on the reverse side. NO entries will be processed without your signature. A "*" NEXT TO ANY FIELD DENOTES A REQUIRED FIELD.BREED*VARIETY (1)SEX*CONFORMATION CLASSES: (no AKC champions of record)*NO CONFORMATIONPUPPY (3 TO 6 MONTHS ) $10.00PUPPY (6 TO 9 MONTHS) $10.00PUPPY (9 TO 12 MONTH S) $10.00ADULT (12 TO 18 MONTH $10.00OPEN ($10.00)NO AKC CHAMPIONS OF RECORD!JUNIOR SHOWMANSHIPJUNIOR SHOWMANSHIP*NO JUNIOR SHOWMANSHIPNOVICE JUNIOR ( $5.00)NOVICE INTERMEDIATE ($5.00)NOVICE SENIOR ($5.00)OPEN JUNIOR ($5.00)OPEN INTERMEDIATE ($5.00)OPEN SENIOR ($5.00)NAME OF (see instructions) HANDLER (if any)DOG / OWNER INFORMATIONNAME OF DOG*REGISTRATION #*REGISTERING ORGANIZATION*AKCPAL/ILP #FOREIGN REGISTRY #PLACE OF BIRTH (enter country below) do not print country in the catalog*DATE OF BIRTH* Date Format: MM slash DD slash YYYY BREEDER*SIRE*DAM*OWNERS NAME #1* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Suffix OWNERS NAME # 2 Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Suffix Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* An acknowledgement and receipt of entry will be sent to this email address.ARE YOU A NEW EXHIBITOR? ( choose one))*NOYESI (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.* I AGREE TO TERMS OF HOLD HARMLESS AGREEMENT ABOVE AKC 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 any additional rules and regulations appearing in the premium list of 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 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 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 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 THIS 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. * I AGREE TO THE AKC AGREEMENT ABOVE SIGNATURE (of owner or his agent duly authorized to make this entry)*Sign with digital pen, finger or mouse.PhoneEmail If this entry is for Junior Showmanship, please enter the following information.ATTENTION JUNIOR HANDLERS:JUNIOR HANDLERS PLEASE FILL OUT AGREE, AND SIGN ALL THE ITEMS BELOW.AKC JUNIOR HANDLER # (optional for match not required)Name First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country (if not in the USA) If this Junior handler is not the owner of the dog identified on the face of this form, what is the relationship of the Junior Handler to the owner?OWNERSHIPBy signing the entry form, I (we) certify that the Junior Showman does not now, and will not at any time, act as an agent/handler for pay while continuing to compete in Junior Showmanship.SIGNATURESECURE PAYMENTFor you security, when you click on the submit button you will leave the wkc site and be taken to a secure Pay Pal site to complete your transaction. A confirmation of your payment will be emailed to you.this is a new service for us and issues can arise. If you experience difficulty do not try and re-enter instead email firstname.lastname@example.org or email@example.com. include your contact number and we will be happy to help you walk through the process. Reference the notice at the top of this form with important information for a successful entry.YOUR PAYMENT TOTAL $0.00 ON BEHALF OF THE WAUKESHA KENNEL CLUB, THANK YOU FOR PARTICIPATING IN OUR MATCH AND SUPPORTING OUR MISSION OF EDUCATION, TRAINING, BREED HEALTH, STANDARD & EXCELLENCE. WE LOOK FORWARD TO SEEING YOU! A CONFIRMATION EMAIL AND RECEIPT WILL BE SENT TO THE EMAIL ADDRESS YOU PROVIDED ABOVE. IF YOU HAVE NOT RECEIVED YOUR CONFIRMATION EMAIL THEN PLEASE CHECK YOUR JUNK OR SPAM FOLDER OR EMAIL YOUR QUESTION TO : firstname.lastname@example.org or email@example.com.FORM INSTRUCTIONS1. (Variety) if you are entering a dog of breed in which there are varieties for show purposes, please designate the particular variety you are entering, i.e., Cocker Spaniel (solid color black, ASCOB, parti-color), Beagles (not exceeding 13 in., over 13 in. but not exceeding 15 in.), Dachshunds (longhaired, smooth, wirehaired), Collies (rough, smooth), Bull Terriers (colored, white), Manchester Terriers (standard, toy), Chihuahuas (smooth coat, long coat), English Toy Spaniels (King Charles and Ruby, Blenheim and Prince Charles), Poodles (toy, miniature, standard). 2. The following categories of dogs may be entered and shown in Best of Breed competition: Dogs that are Champions of Record and dogs which, according to their owners’ records, have completed the requirements for a championship, but whose championships are unconfirmed. The showing of unconfirmed Champions in Best of Breed competition is limited to a period of 90 days from the date of the show where the dog completed the requirements for a championship. 3. (Event Class) Consult the classification in this premium list. If the event class in which you are entering your dog is divided, then, in addition to designating the class, specify the particular division of the class in which you are entering your dog, i.e, age division, color division, weight division. 4. A dog must be entered in the name of the person who actually owned it at the time entries for an event closed. If a registered dog has been acquired by a new owner it must be entered in the name of its new owner in any event for which entries closed after the date of acquirement, regardless of whether the new owner has received the registration certificate indicating that the dog is recorded in his/her name. State on entry form whether transfer application has been mailed to the AKC. (For complete rules, refer to Chapter 11, Section 3.) 5. Mixed Breed dogs entering classes for Agility, Obedience, and Rally trials should mark Breed as “All-American Dog/Mixed Breed.” Sire and Dam information shall remain blank for mixed breed entrants. 6. JUNIOR SHOWMANSHIP If this entry is for Junior Showmanship, please enter the following information. AKC Junior Handler Number Junior’s Date of Birth The Junior Handler number MUST be included. Should you not have your Junior Handler number, it may be obtained from the American Kennel Club, phone (919) 233-9767. Junior Handler’s Address City State/Province Zip/Postal Code Country (if not USA) By signing the entry form, I (we) certify that the Junior Showman does not now, and will not at any time, act as an agent/handler for pay while continuing to compete in Junior Showmanship. ■If this Junior Handler is not the owner of the dog identified on the face of this form, what is the relationship of the Junior Handler to the Owner?