SOUTHWESTERN REGIONAL
IPO3 CHAMPIONSHIP
Hosted by AZTEC SCHUTZHUND CLUB
USCA, USCA/SV Judge Ernest Hintz - Tracking
USCA, USCA/SV Judge Mike Caputo, Obedience - Protection
February 15, 16, 17, 2013
RAMONA, CA, 92065
500 AQUA LANE
**Non USCA Members add $15 per entry**
Submit all Entries to the Trial Secretary no later than: February 01, 2013Make checks payable to: AZTEC SCHUTZHUND CLUB
Mail entries to: John Boyer, PO Box 2572, Ramona, CA, 92065
Email:
Entry Fees: $125.00
Entry form must be filled out completely and payment included for entry acceptance, submit copy of current USCA Membership Card
Dog Information
Registered Name of Dog
Call Name / Current Title(s)
Registration # / Registration Organization
Breed / Sex
Date of Birth / HOT (Circle) Yes No
USCA Scorebook # / Non-USCA Scorebook #
Must be stamped by USCA and include letters provided by USCA
Tattoo # / Microchip #
Entry Information
Entry (circle) - IPO 1 2 3 -
Entry Fees Enclosed $ / Check #
Handler Information
Name of Handler
Handler E-Mail / Phone
Address: / City State Zip
USA Membership # / Expiration Date
Date BH Acquired / Place BH Acquired
Owner Information (if different than handler)
Name of Owner / Phone
Address / City State Zip
USA Membership # / Expiration Date
Liability Waiver
Please read carefully: I understand that it is my responsibility at this event to keep my dog(s) under control at all times. I agree to be fully responsible for the actions of my dog(s) while on the trial grounds. I further agree to hold harmless the United Schutzhund Clubs of America, AZTEC SCHUTZHUND CLUB, property owners, members, officers, directors, and spectators for any loss or injury which may be allegedly caused directly or indirectly to any person, animal, or possession by any act of my dog(s) or to my dog(s) while on the premises of this trial site.
I hereby assume all responsibility and liability for any such claims and agree to hold harmless and relinquish all claims to AZTEC SCHUTZHUND CLUB, property owners, United Schutzhund Clubs of America, members, and spectators. I understand that this event will be conducted in accordance with the current VDH rules and regulations as administered by the United Schutzhund Clubs of America (UScA).
In consideration for acceptance of this entry, I agree to abide by these rules regulations and decisions. It is further understood that the Trial Secretary has the right to dismiss any dog or handler for violation of the VDH rules or for unsportsmanlike conduct. In the event of dismissal, any entry fees will not be refunded.
I represent that I am over the age of 18 and am otherwise mentally and legally competent to execute this agreement on my own behalf or on behalf of a youth handler of whom I am parent or legal guardian.
Owner/Handler/Guardian: ______Date: ______
The Draw will be held 6:30 pm Friday at the Ramona Valley Grill, 344 Main St, Ramona, CA, 92065.
The Regional Meeting and Judges Dinner will be held Saturday at the Host Hotel, The San Vicente Resort, 24157 San Vicente Rd, Ramona, CA 92065. Dinner will cost $25.00 per person. Competitors cost is included in the entry fee. Please RSVP how many additional people will be having dinner. ( )
The Regional meeting room will be open at 6:30 pm for hors d’oeuvres; the meeting will begin at 7:00 pm. Dinner will be served immediately after the meeting.