One form may be used for multiple-day entries of the same dog. Check the appropriate box next to the class that you are entering your dog for each day the dog will be exhibited. Completely fill in all information pertaining to the dog that you are entering.
Do not complete this form until you have read the waiver.
NLC:( Nov Puppy, Stud Dog, Brood Bitch, Veteran, $8.00
Junior Showmanship: $10.00
(No fee for Pee Wees and Sub Juniors)
Day of Show $25.00
Breed of Dog ***
(if applicable)
Variety of Dog
Dog may not be entered without a permanent UKC registration number,
A UKC Temporary Listing (TL) number or a UKC Limited Privilege (LP) number.
Choose one of the three types of registration below and entry your dog's number.
If your dog's permanent registration is pending at UKC,
and you do not have a valid TL number, your entry will be invalid.
Registered As ? ***
U.K.C. Registration/Listing Number ***
Date of Birth (mm/dd/yyyy) ***
Name of Dog ***
Sex ***
CONFORMATION CLASSES
WAIVER
All events are held under the Official Rules and Regulations of the United Kennel Club, Inc.
Absolutely no alcoholic beverages, gambling, illegal drugs or firearms will be allowed on the grounds
or in the buildings on the day of a UKC Licensed event. UKC, its agents and employees, and the host
club assume no responsibility for any loss, damage, or injury sustained by spectators or by exhibitors
and handlers, or to any of their dogs or property, and further assume no responsibility for injury to children
not under the control of their parents or guardians. UKC and the host club are not responsible for
loss, accidents or theft.
By signing this form, I hereby agree to waive any claim, action, or lawsuit and further agree to
indemnify and hold UKC, the host club and any approved UKC Judge harmless from any claims,
actions or lawsuits resulting from my participation in this event, and any action, decision or judgment
made by any UKC or host club representative or approved Judge under the official UKC Rules and
Regulations governing this event. I acknowledge that the current Official UKC Rules and Regulations
(Agility, Conformation, Dog Sport, Junior Showmanship, Obedience, Terrier Race, Weight Pull) have
been made available to me, and that I am familiar with their contents. My signature indicates that I understand
and agree to the above and to abide by all of the current Official UKC Rules and Regulations
I Agree I have read and agree to the waiver on this electronic entry form. I swear this dog is not being handled by a professional handler in Conformation
Box must be checked-- entry wil not be accepted if blank.
Owner's name(s) ***
Address ***
City ***
State ***
Zip Code ***
Telephone:Days ***
E-mail address
Entry Fees:
NLC: $8.00
Day-of-show Entry Fee: $25.00
Junior Showmanship : $10.00
IMPORTANT
Before pressing "submit," double check the previous information to make sure it is accurate. If you do not include an email address, confirmation cannot be sent after receipt of application.
By pressing the following button labeled "Submit Application" I understand that doing so is in lieu of an actual signature, and that the information entered above is correct to the extent of my knowledge. Furthermore, I swear that this dog is not being handled by a professional handler and that I understand and agree to abide by all of the current official United Kennel Club rules and regulations.
Secure Online Payment
When you click the Submit button.
You will be taken to the Thank you page.
Follow step 2 to make Secure Online payment.
On the next page there is a list of all shows, (on the left) click on Glen of Imaal Terrier Club
A $3.50 Handling fee will be charged to your credit card .
