Arkansas Kennel Club, Inc.
Date: August 8th, 2014
AKC Sanctioned B Match Entry Form
Breed: _______________________________________ Sex: M__________ F: __________
Class: 3-6 Mos. ____________ 6-9 Mos. ____________ 9-12 Mos. ___________ Open ________
Group: Sporting _______________ Hound _________ Working ______________ Terrier _______
Toy ________ Non-Sporting _________ Herding ________ Misc. _________ FSS __________
Junior ShowmanshipJunior's Name: _______________________________________________
Junior's Class: Novice: ___________ Open: _____________ Master: _______________
Junior (9-12 yrs. ) _______ Intermediate: (12-15 yrs.) ________ Senior: (15-18 yrs.) ________
I/we agree to be bound by the "Agreement" printed on the reverse side of this entry form. I/we certify and represent that the dog entered is not a hazard to persons or othe dogs. This entry is submitted for acceptance on the foregoing representation and agreement.
Signature: ______________________________________ Date: ____________________
(Signature of parent if under 18)
Make Check payable to: Arkansas Kennel Club, Inc.
Mail to: Sherri Rohm 30 Holland Hills Loop, Vilonia, AR 72173
For Match Secretary Use:
Amount of Payment Received: ______________ Armband # __________________
Agreement:I (we) agree that the club holding this event has the right to refuse this entry for cause which the club shall deem sufficient. In consideration of the acceptance of this entry and of 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 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 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 tme 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 any of their employees, agents, or any persons.
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 ITS PREMIUM LIST) AND MYSELF (OURSELVES) OR AS TO THE CONSTRUCTION, INTERPRETATION AND EFFECT OF THIS AGREEMENT SHALL BE SETTLED BY ARBITRATION ASSOCIATION. HOWEVER, PRIOR TO ARBITRATION ALL APPLICABLE AKC BYLAWS, RULES, REGULATIONS, AND THE AKC PROCEDURES MUST FIRST BE FOLLOWED AS SET FORTH IN THE AKC CHARTER AND BYLAWS, RULES, REGULATIONS, PUBLISHED POLICIES AND GUIDE.
You may pay via PayPal for your convenience.There will be an additional $1.50 for using PayPal.