OFFICIAL UNITED KENNEL CLUB CONFORMATION ENTRY FORM

FOR CLUB USE ONLY
OFFICIAL UNITED KENNEL CLUB CONFORMATION ENTRY FORM
Please print or type all information. Do not complete this form until you have read and signed the waiver.
Invalid without signature.
HOST CLUB______________________________________________
Date
Date
Show 1/JS1
Show 2/JS2
Date
Show 1/JS1
Show 2/JS2
Show 1/JS1
Show 2/JS2
Date
Show 1/JS1
Show 2/JS2
Dog must not be entered without a permanent UKC® registration number or a UKC® Temporary Listing number. Check
one of the two boxes below and enter 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.
Dog’s
UKC permanent reg.
UKC TL
UKC (PL/LP) #__________________________________
Breed of dog:______________________________ Variety (if applicable):___________ Sex:____
Dog’s Name: ____________________________________________________________________
Call Name: ______________________________________ Date of Birth: ____________________
Junior Name: ____________________________________Junior #: ________________________
(if applicable)
Dog owner’s name(s): ____________________________________________________________
Address: ________________________________________________________________________
City: ____________________________________ State: ______________ ZIP ________________
Telephone (day):__________________________________ (eve):__________________________
Email: __________________________________________________________________________
Please check the box for the appropriate class.
Conformation (Only Choose One)
Puppy (6 months-under 1 year)
Junior (1 year-under 2 years)
Intermediate (2 years-under 3 years)
Adult (3 years & over)
Breeder & Handler (6 months & over shown by
breeder)
Champion (CH)
Grand Champion (GRCH)
Non-Licensed Class: _________________________
Junior Showmanship
Classes
Pee Wee (2 years-4 years)
Sub JR (4 years-6 years)
Pre-Junior (6 years-8 years)
Novice Junior (8 years-13 years)
Open Junior (8 years-13 years)
Novice Senior (13 years-18 years)
Open Senior (13 years-18 years)
Dog weight: ________________________
IMPORTANT INFORMATION ABOUT THIS ENTRY FORM:
1. All entries must be submitted on the current “Official UKC® Entry Form”. You may use one entry form
to enter the same dog in more than one show on the same weekend.
2. Use a separate entry form for each dog entered in a club's event.
3. Mail all completed entry forms to the Event Secretary listed under the event, unless otherwise
specified. Make checks payable to host club.
4. We want you to keep the points earned at UKC Licensed events. Important things to remember:
• Dog not UKC registered? Apply for a Temporary Listing Number (TL) online at www.ukcdogs.com or call the
Dog Events Department at (269) 343-9020. (TL fees are non-refundable, non-transferable and do not apply
to the cost of permanent registration.)
• All dogs entering UKC events must be permanently registered, have a valid
Temporary Listing Number, or a Performance Listing/Limited Privilege number.
• All entry forms must be completed and signed. Incorrect information submitted on the entry form may
invalidate your wins.
• To be eligible to enter into the Breeder/Handler class, you must be one of the breeders of record, or
a member of the immediate family of one of the breeders of record. Immediate family includes:
spouse, parent, step-parent, child, step-child, sibling, grandchild, or in-law, so long as the handler is
not a professional handler as defined by UKC Rules and Regulations.
WAIVER
All events are held under the Official Rules and Regulations of the United Kennel Club. Absolutely no
alcoholic beverages, 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,Dock
Jumping, Drag Race, Junior Showmanship, Lure Coursing, Obedience, Rally Obedience, 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 have read and agree to the waiver on this form. I swear that this dog is not being handled by a
professional handler in Conformation.
Altered Conformation
(Only Choose One)
Puppy (6 months-under 1 year)
Junior (1 year-under 2 years)
Intermediate (2 years-under 3 years)
Adult (3 years & over)
Breeder & Handler (6 months & over shown by
breeder)
Champion (CH)
Grand Champion (GRCH)
Armband: __________________________
Entry Fee:
Signature of Owner/Handler
Total Dog/Total Junior
Total Dog
Total Junior Participant
If owner is a minor/Signature of Parent or Guardian
Date
Date
FO136FBL/Rev. 11-15