CCSDT ENTRY FORM

Claycreek Ranch Stock Dog Trial September 14-15

Fee enclosed: $_________ Pre-entries close Friday, September 6, 2024

Make checks payable to Wendy Peters, Mail entry form to Wendy Peters, 845 220th St. Aledo, IL. 61231

Pre-entries are $40/class for sheep and ducks, $50.00 for cattle. FEO entries $30/class for sheep and ducks, $40.00 for cattle. . Gate entries are $45/class for sheep and ducks, $55 for cattle.

Pre-entries for HRD are $45 for sheep. Gate entries for HRD are $50 for sheep..

Full Name of Dog ___________________________________________________ Call Name______________________

Registry and Registration Number or AHBA Tracking Number _______________________________________________ If dog doesn’t have a number you can obtain a Tracking number from AHBA. Breed_______________________________________ Date of Birth__________________________ Sex____________ Sire______________________________________________ Dam___________________________________________ Breeder__________________________________________________________________________________________ Owner___________________________________________________________________________________________ Owner Address____________________________________________________________________________________ Owner Phone Number________________________________ E-Mail_________________________________________ Handler’s Name, if applicable_________________________________________________________________________

ENTRY FORM

Clayceek Ranch AHBA Tests/Trials September14-15 , 2024 Make checks payable to Wendy Peters. Mail completed entry form and signed

Agreement with fees to Wendy Peters, 845 220th St. Aledo, IL. 61231. No acknowledgements will be sent. Pre-entries are $40/class. FEO entries (if

available) $25/class. Gate entries (if available) $45/class NOTE: changes made after closing date are subject to an additional $5.00 admin fee.

Check the box for the classes you want to enter and CIRCLE the Level, Stock, and Leg/CH (if applicable).

LIVESTOCK – Painted Desert sheep value $200; Ducks $25 value. Cattle 1200.00 value. Any livestock

seriously injured while being worked must be paid for by the participant working stock at that time.

DAY CLASS LEVEL STOCK

SAT HRD I II III Sheep. ❑ SAT HTAD I II III Sheep Ducks Cattle

❑ SAT HTD I II III Sheep Ducks Cattle. ❑ SAT JHD Leg 1 2 Sheep

❑ SAT HCT Leg 1 2 Sheep. SUN HRD I II III Sheep Cattle

❑ SUN HTAD I II III Sheep Ducks. ❑ SUN HTD I II III Sheep Ducks Cattle

❑ SUN JHD Leg 1 2 Sheep. ❑ SUN HCT Leg 1 2 Sheep

THIS MUST BE SIGNED BEFORE ENTRY CAN BE ACCEPTED.

Entry Agreement and Indemnity

The person who signs this Entry represents that she/he is authorized to enter into thisAgreement and Indemnity on behalf of both the Handler and Owner of the entered dog inconsideration of acceptance of this entry.Handler and Owner whether or not members of American Herding Breed Association(“AHBA”) agrees to abide by the rules and regulations of AHBA and all other rules and/or regulations shown in the premium list for this event.Handler and Owner certify that the entered dog is not a hazard to persons, dogs orproperty. In the event the entered dog injures any livestock, the owner will pay for veterinarian services. If the injury is severe, the owner will pay the market value or value stated in the premium list of the stock injured.Handler and Owner acknowledge that herding events are inherently dangerous and have risks of injury to persons. Handler and Owner agree to assume the risk of any harm arising from the hazards associated with the herding event which include but are not limited to, parking areas, ground conditions, animals, stock used in the herding event, and other dogs. Handler and Owner hereby release AHBA, its officers, directors agents and members, including Wendy Peters, Claycreek Ranch (its officers, agents and directors) and the owners of the site of the event, from any and all liability for any injury, loss or damage, of whatever kind or nature, whether to person or property which occurs directly or indirectly or associated with the herding event. Handler and Owner agrees to indemnify and hold harmless AHBA, its officers, directors agents and members, including Wendy Peters, Claycreek Ranch(its officers, agents and directors) and the owners of the site of the event, from any and all claims, loss or expense, including attorney’s fees, arising out of any injury, loss or damage, of whatever kind or nature, whether to person or property which occurs directly or indirectly or associated with acts or failure to act of Handler or Owner, or any of the dogs entered in the herding event or brought to the site of the herding event. __________________________________________________Signature of Entrant