KAOS Dogsports Inc.

AAC Official Entry Form

LIMITED ENTRY

Opening Date: August 15, 2015/ Closing Date: September 19, 2015

PRICING:

Two Day Workers Package (9 events) - $128/dog

Saturday Workers Pkg (5 events)$75/dog; Sunday Workers Pkg (4 events)$60/dog

Individual rounds (workers): $16 /Individual rounds (Non-Worker): $21

Individual Team Run (workers) $9; Individual Team Run (non-workers) $12

If you do not mark down to work, you must pay the non-workers price!

Please make cheques or money order payable to:

KAOS Dogsports Inc.

E-transfer and PayPal is also available. Email for additional information. PayPal fee of $3/entry will be added to the PayPal payment request. Do not send a PayPal payment before you receive a request.

Tendering of a NSF cheque shall be considered non-payment of entry.

There will be a $25.00 NSF Service Charge on all return cheques.

Mail/Courier Entries to:

KAOS Dogsports Inc.

1311 Ottawa Street

REGINA SK S4R 1P3

Email entries to:

WORKERS TRIAL – PLEASE INDICATE YOUR PREFERENCE

______Timer ______Scribe

______Ring Crew (poles, etc) ______Gate Steward

______Leash/Sheet Runner______CourseBuilding

“Many hands make light work!”

Handler’s Information
Name:
Address:
City: Prov:
Postal Code: Phone #:
Email:
Dog’s Information
Dog’s Registered
Name:
Handler:
(if different than owner)
Call Name: Birth date:
Breed: AAC Card #
Height dog will jump at the trial (circle one)
Height at withers:
6” 10” 16” 22” 26”
Circle Division: Regular Veterans Specials

Entry will not be valid unless signed, dated,

and submitted with correct fee.

Choose Payment Type / CASH / CHEQUE / PAYPAL / EMT
Two Day Workers Package / $128
Saturday Workers Package / $75
Sunday Workers Package / $60
Worker Individual Runs / $16 ea / ______# runs / Owing:
Non-Worker Individual Runs / $21 ea / ______# runs / Owing:
TEAM: Worker Individual Runs / $9
TEAM: Non-Worker Individual Runs / $12
Please Check Appropriate Level an `X`
SATURDAY / Starters / Advanced / Masters
Standard 1
Standard 2
Steeplechase (one level only)
Team Relay (one level only)
Do you NEED a Team Partner? (please circle one) YES NO
HAVE a Partner? Please list Partner Handler & Dog Name:______
Snooker 1
SUNDAY / Starters / Advanced / Masters
Gamble
Snooker 2
Jumpers 1
Jumpers 2
Camping: Non-Power (please circle) / $20
Camping: Power (please circle) / $30
PayPal Fee Add $3/entry (please circle) / $3
Total Paid (fees & others)

Notice to Exhibitors

Exhibitors, through submission of entry, acknowledge that they are fully knowledgeable of AAC rules and regulations, including but not limited to the following:
This event is open to all dogs being at least 18 months of age, regardless of pedigree, except bitches in season, aggressive dogs, or, dogs suffering from any deformity, injury or illness which may affect the dog’s physical or mental performance, or any dogs showing signs of aggression.
Obstacles chosen from those described in the current edition of the rules and regulations of the AAC. A breakaway tire will be in use during the trial.
No leads, collars, food, toys or other aids or devices shall be permitted on the course at any time. It is expressly understood that exhibitors alone are responsible for the behaviour of their dogs and/or children. Any exhibitor, whose dogs and/or children create an unnecessary disturbance or repeatedly engage in unsafe or disruptive behaviour, may be asked to leave the show grounds and no refund of fees will be made.
Exhibitors must keep crate and exercise areas clean. Please pick up after yourself and your dogs.
There will be no refund after the closing date for dogs that are withdrawn, with the exception or bitches in season or injuries with a vet certificate.
The Trial Committee has the right to refuse any entry for causes which they deem sufficient.
The Saskatchewan Freedom of Information and Protection of Privacy Act: enacted January 1st, 2004; requires that consent be obtained for the collection and use of personal information. The information collected by KAOS Dogsports Inc., will be used for registering competitors in agility events and for contacting competitors by email or mail for future agility events, such as trials and seminars.
Allinformation collected from or pertaining to all competitors will be kept private and confidential unless authorized in writing by the competitor. All paper copies of entries containing personal information will be destroyed after a period of 6 months. Your entry into this trial will be added to list of exhibitors available to all attendees. If you do NOT want your name and information entered into the exhibitors list please check the box below.
Please check this box if you DO NOT want your information published in the Exhibitors List ____

Any dog earning a title after the closing date of this trial is eligible to move up to the

/ Agility Association of Canada General Agreement
I/ We, the undersigned, agree that the host club has the right to refuse my entry for causes which the organizing committee shall deem to be sufficient.
In consideration of the acceptance of this entry and the holding of the event and the opportunity to have the dog participate, or be judged.
I/ We agree to hold the organizing committee, the organization which it represents including its members, officers, and directors, the Agility Association of Canada, sponsors of the event, owner of the premises upon which the event is being held and their employees, harmless from any claims for loss or injury which may be alleged to have been caused directly or indirectly to any persons or thing by the act of this dog while in or upon the event premises or grounds or near entrances thereto, and I/ We personally assume all responsibility and liability for any such claim.
I/ We further agree to hold the aforementioned parties harmless from claims of this dog by disappearance, theft, death or otherwise from any damage or injury to the dog, whether such loss, disappearance, theft, death or otherwise be caused or alleged to be caused by negligence of the parties aforementioned, or by negligence of any person, or any cause or causes.
I/ We hereby assume the sole responsibility for and agree to indemnify 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 caused by bodily injuries, including death at any time resulting thereof, 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 damage to property may be caused and whatever or not the same may have been alleged to have been caused by negligence of the aforementioned parties or any of their employees or agents or any other persons.
I CERTIFY that I am the actual owner of the dog, or that I am the duly authorized agent of the actual owner of the dog entered hereon. In consideration of the acceptance of this entry, I (we) have read, understand and will abide by the Official Rules and Regulations of the Agility Association of Canada, Inc. in effect at the time of this entry, and by any additional rules and regulations appearing in the Agility Trial Schedule for this event. I (we) certify and represent that the dog entered is not a hazard to persons or other dogs. This entry is submitted for acceptance on the foregoing representation and General Agreement/Disclaimer. I (we) agree to conduct myself (ourselves) in accordance with such Official Rules and Regulations (including all provisions applying to discipline) and to abide by any decisions made in accordance with them.

______

Signature Date Signature of Parent or Guardian Date

Entry not valid unless signed dated and submitted with fees by closing date.In the event the entrant is under the age of 18 years old, entry must be signed and

dated by a parent or legal guardian.