Oklahoma 4-H Dog Show Entry Form

OKLAHOMA 4-H DOG SHOW ENTRY FORM

FOR: TULSA STATE FAIR (Ford Truck Arena) Mail Entries to: Oklahoma 4-H

OCTOBER 9, 2016 205 4HYD

Stillwater, OK 74078

ENTRIES DUE BY SEPTEMBER 10, 2016

4-H Member Name ______Age (Date of Show) ______

Address ______County______

Town ______Zip ______Tel. No ______

Name of Dog ______Breed or Type ______Age of Dog _____Sex____

EMAIL ADDRESS ______

Check classes you plan to enter:

Showmanship Obedience Rally Agility

_____ Novice Jr. _____ Open _____ Novice A ** ____ Pre-Agility

_____ Novice Sr. _____ Graduate Novice _____ Novice B ____ Agility I

_____ Open Jr. _____ Novice _____ Advanced ____ Agility II

_____ Open Sr. _____ Sub-Novice _____ Excellent ____ Agility III

_____ Beginner B

_____ Beginner A **

** This class is limited to 4-H members who have never shown a dog in any obedience/rally trial.

Required Signatures:

Extension Educator: / I certify that the youth entering and showing this dog has been a 4-H member for 30 days prior to show and is enrolled in the 4-H Dog Project and the Dog entered is a part of the 4-H Member’s Dog project.

______…..______

Signature of Extension Educator County

Parent / The undersigned exhibitor and parent assume all risk of damage or loss either to person or property, from all and every cause whatsoever, including negligence, either on the part of the Oklahoma State University Extension Service, its officers servants, agents or employees, and I further agree to indemnify the O.S.U. Extension Service, its officers and members against all suits and expenses arising out of any injury claims, demands by any person, or damage to any property caused by my animal(s).
This dog is a part of my/our child’s dog project and was trained by him/her. This dog does not hold any obedience titles other than those earned by 4-H member. To my knowledge the dog presents no discipline problem to the public. We accept all liability for any personal injury this dog causes.
Attach copy of vaccination certificates. All rabies vaccinations must be current and given by a Licensed Veterinarian.
Distemper, hepatitis, leptospirosis, and parvovirus must also be documented either by a veterinarian or records showing the date the vaccinations were given plus the coded label showing contents and expiration date.
THE TULSA STATE FAIR REQUIRES HEALTH PAPERS ON YOUR DOGS. YOU WILL BE ASKED FOR A COPY OF THE HEALTH PAPERS AND RABIES VACCINATION PAPERS BEFORE YOU WILL BE ALLOWED TO ENTER THE FAIR GROUNDS.

______

4-H Member Signature Parent/Guardian Signature

County______

G:\FourH\Companion Animals\OKC and Tulsa Fairs\2014 Tulsa Dog Show\4-H STATE FAIR Tulsa Dog Entry Form (State)2014.doc State Fairs Resource Notebook, Page C-2