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CHAMPIONSHIP & QUALIFYING SHOW RETURN OF SHOW ENTRIES/FEES

(In accordance with Schedule 3, Reg. 7.8; Schedule 4, Reg. 6; Schedule 4A, Reg. 9.11 TO BE COMPLETED AND RETURNED WITHIN FIFTEEN (15) WORKING DAYS OF THE CLOSING OF THE SHOW.)

THIS FORM MUST ACCOMPANY THE PAYMENT AND PREFERABLY THE CATALOGUE TO BE SENT AT THE SAME TIME.

NAME OF CLUB: ______ORG NO: ______

DATE OF SHOW: ______

SHOW NUMBER: (If a Club applied for a 2nd Champ show, please indicate 1st or 2nd Show): ______

FOR KUSA STATS PLEASE INDICATE THE NUMBER OF DOGS ENTERED INTO EACH DISCIPLINE:

DISCIPLINE / NO ENTRIES / ABS / DISCIPLINE / NO ENTRIES / ABS / DISCIPLINE / NO ENTRIES / ABS
BREED / FLYBALL TEAMS / APTITUDE/DMA
OBEDIENCE / WORKING TRIALS / BA/BST
DOG JUMPING / WORKING UTILITY DOG / BWT/CBA
CARTING / TRACKING TRIALS / RESCUE DOG
AGILITY (ALL) / IPO (All) / DOG DANCING
Show Levies to KUSA / A / B / C / D
You pay on the number of dogs “ENTERED”
ONCE ONLY / Total Individual Dogs Entered / ABS / Total NO Entries Across All Disciplines / Total dogs Present
= A - B / LEVY PAYABLE
= A* LEVY AS DETERMINED ANNUALLY
CHAMPIONSHIP SHOW
(ALL CLUBS – per dog entered) / R20.00 per dog (incl. VAT)
QUALIFYING SHOW
(ALL CLUBS – per dog entered) / R10.00 per dog (incl. VAT)
CHAMPIONSHIP FLYBALL
(per team entered) / R63.00 (incl. VAT)
QUALIFYING SHOW
FLYBALL
(per team entered) / R32.00 (incl. VAT)
TOTAL AMOUNT PAYABLE / R
NOTE: At any Show held under a Single License, each dog listed in the Official Show Catalogue must be counted once only regardless of whether or not it was present and exhibited and the number of classes or events entered. Fees must be sent for the number of dogs entered “once”. / PAY KUSA the total of R20.00 per dog to – FIRST NATIONAL BANK
Branch Code 202509
Account No: 51450025635
Beneficiary Reference: Org Number followed by “levies”
DSP (Dog Show Program) Only applicable if program was used. / R1.50 per dog (incl. VAT) / FOR DSP PAYMENTS ONLY
Pay directly to GRP EVA
ABSA Savings Account: 23137348
Branch Code: 632005
Reference: DSP+KUSA Club Org number
NUMBER OF DOGS / Total Amount / R

Signature of Secretary: ______

Signature of Treasurer: ______

Date: ______

(If the same person hold the offices of Secretary & Treasurer, the signature of another authorized member of the Club Committee must be obtained). Please ensure that the Stewards names for all theBreed Shows are sent or placed inside your marked catalogues. V.01.04.18