Herding Seminar  & Conformation Fun Match

Herding Seminar : November 8,2008  & November 9,2008   Conformation Fun Match: November 8,2008

Location: Robertsdale Alabama

Conformation fun match, food and drinks are included with all herding entries.

Entry circle:   working   observer   herding instinct test    herding match (advanced dogs)    conformation match           Entry Day circle:   Saturday   Sunday

I enclose $___________________ for entry fees. Please make checks payable to the Southeast Border Collie Club.  

Mail to: Renea Windley 4610 Hwy 196 Molino Fl. 32577

 Name of Handler (Please Print): _______________________________________________________________

I certify that I am the actual owner of the dog, or that I am the duly authorized agent of the actual owner whose name I have entered above. In consideration of the acceptance of this entry, I (we) agree to abide by the herding rules and regulations of the Southeast Border Collie Club and the Southeast Border Collie Club by-laws in effect at the time of this event and by any additional rules and regulations appearing in the premium list for this event and further agree to be bound by the “Agreement” printed on this entry form. 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 & agreement.

 Signature: ______________________________________________________

Owner or agent duly authorized to make this entry

Phone Number:_____________________________

E-Mail Address:_____________________________

An acknowledgment or receipt may be sent to this e-mail address

Breed: ________________________________________________________

Sex: ___________         Date of Birth: ____________

Circle your Livestock experience: None   Beginner   Experienced

If you are trialing with your dog list titles: ________________________________

Full Name of Dog:__________________________________________________

Call Name:________________________________________________________

For Match Circle one

Classes: 6/9     9/12     12/18     Open     Bred By    Best of Breed

Full Name of Dog:__________________________________________________

AKC Reg. No. / AKC Litter No./ ILP No. or

Foreign Reg. No. & Country:__________________________________________

Breeder:__________________________________________________________

Sire:_____________________________________________________________

Dam:____________________________________________________________

Actual Owner(s):___________________________________________________

Owner’s Address___________________________________________________

City, State, Zip:_____________________________________________________

AGREEMENT

I (we) acknowledge that the Southeast Border Collie Club Regulations for Herding Seminar  and Southeast Border Collie Club by-laws have been made available to me (us), and that I(we) agree that the club holding this Herding Test or Trial has the right to refuse this entry for cause, which the club shall deem to be sufficient. In consideration of the acceptance of this entry and of the holding of the Herding Seminar and of the opportunity to have the dog worked,, I (we) agree to hold this club, its members, directors, governors, officers, agents, superintendents or show secretary and the owner or lessor of the premises and any employees of the aforementioned parties harmless from any claim for loss or injury which may be alleged to have been caused directly or indirectly to any per-son or thing by the act of this dog while in or upon the Herding  premises or Seminar grounds or near any entrance there to, and I (we) personally assume all responsibility and liability for any such claim for damage or injury to the dog, whether such loss, disappearance, theft, damage or injury, be caused or alleged to be caused by the negligence of the club or any of the parties aforementioned, or by the negligence of any other person, or any other causes. I (we) hereby assume the sole responsibility for and agree to indemnify and save the aforementioned parties harm-less 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 because of bodily injuries, including death at any time resulting there from, 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 Herding Seminar

howsoever such injuries, death or damage to property may be caused, and whether or not the same may have been caused or may be alleged to have been caused by negligence of the aforementioned parties or any of their employees or agents, or any other persons. I (we) will pay for any livestock injuries or replacement value in the event of death of any livestock by my (our) dog. In case if any injury to any stock caused by the dog entered, I (we) will assume total responsibility for any dam-age. I (we) agree to pay the full market value of the injured animal in case of serious injury, or the veterinarian bill if the injury is slight.

Signature: ______________________________________________________