Sunday, December 7, 2014 Leesburg, VA UScA/SV Judge William Szentmiklosi

Sunday, December 7, 2014
Leesburg, VA
with UScA/SV Judge William Szentmiklosi
TRIAL LOCATION:
TRIAL HELPERS:
TRIAL REGISTRATION:
TRACKING START TIME:
21900 Foxden Lane, Leesburg, VA 20175
Brandon Jensen & Marty Segretto
7:00 am
8:00 am, with Obedience and Protection to follow
MAIL ENTRIES: c/o Marty Segretto
6101 Pine Crest Lane, Frederick, Md. 21701
email: [email protected]
MAKE CHECKS
PAYABLE TO:
DOG-FRIENDLY
LODGING:
Alexandria Schutzhund Group
Days Inn,
721 East Market Street, Leesburg, VA 20176
(703) 777-6622
Sunday, December 7, 2014
I am registering for (please circle appropriate title):
$65 –
IPO
$55 –
BH
I
II
III
OB1 OB2 OB3
NOTE: There will be a $15 late fee for entries
postmarked after November 28, 2014.
Non-UScA members will be charged an additional
$15 entry fee. (This surcharge is not ASG’s choice,
but a UScA ruling.)
Owner’s/Handler’s Statement
I understand participation at this trial is at my own risk. I
will not hold ‘Alexandria Schutzhund Verein’ or any of its
members responsible for damages that may occur to my
person or property or dog as a result of this club. I
understand that I am fully responsible for the actions of
my dog.
All entries made in this application from are true and
correct.
I verify that the dog attending has all vaccinations up to
date. It is also understood by every handler/owner and
exhibitor that every dog at this trial will at all times be in
the care, control and custody of the owner and also
agree to assume full responsibility for the dog and its
actions at all times.
Please arrive before 7 am to register.
Print and fill out the form completely.
______________________________________________
Dog’s Registered Name
______________________________________________
Scorebook #
Chip/Tattoo #
______________________________________________
Date of Birth
M F
Breed
______________________________________________
Reg # (AKC / SV / Other)
H.O.T.?
______________________________________________
Dog’s Previous Titles
______________________________________________
Owner’s Name & UScA member #
______________________________________________
Owner’s Address
______________________________________________
Owner’s Phone Number
Owner’s Email
______________________________________________
Handler’s Name & UScA member #
______________________________________________
Handler’s Address
______________________________________________
Date
Print Name
______________________________________________
Handler’s Phone Number
Handler’s Email
______________________________________________
Owner/Handler Signature
______________________________________________
MAIL TO:
Marty Segretto
6101 Pine Crest Lane,
Frederick, Md. 21701
Foreign scorebooks, DVG Scorebooks, AWDF Scorebooks
and all other FCI approved scorebooks must be approved
and certified by USCA and given a number. A $50
scorebook bond will be collected from the handler if a
dog is shown without a USA scorebook or a USA certified
foreign scorebook being presented to the Trial Secretary
prior to the start of the event.