ADCV NADAC Trial Entry Form

Please read the ADCV NADAC trial premium document before completing your entry. The premium document can be found on the NADAC Australia website on the calendar page under the ADCV trial date.

The online entry form has provision for entering up to 6 dogs on the same form. When completing your entry, please ensure all fields marked with a red asterix are completed.

Trial entry fees can be made by direct bank deposit. Entry fees must be received before the entry closing date.

Once you have completed your entry, please click the submit button. Your entries will be submitted electronically.

Entries close by end of day Friday 4th December 2020.

Owners Name

First NameLast Name

Owners Phone

Email

Your entry confirmation will be sent to this address

Address (To ensure we have up to date details, please provide your current mailing address)

Street Address / PO Box No.

Street Address Line 2

CityState

Post Code

Emergency Contact Person Name

First NameLast Name

Emergency Contact Phone

How many dogs are you entering

Dog (1) Call Name

NADAC Number-Dog (1)

Please type in the correct format eg. 00-00000

Breed-Dog (1)

Date of Birth-Dog (1)

If using the calendar, select Year-Month-Date

Height at Shoulder in Inches-Dog (1)

Jump Height-Dog (1)

Prior to exemptions, divisions or categories

Breed Height Exemption-Dog (1)

What Category are You Entering-Dog (1)

Dogs Division-Dog (1)

Would you like Ribbons or Dog Treats, should you Qualify or Place with this dog

Is the Handler the same person for all dogs? When yes is selected, the handler details will be hidden for all remaining dogs to be entered.

Handlers Name

First NameLast Name

Handler Division

RUNS ENTERED FOR DOG (1)

Rows	ELITE	OPEN	NOVICE	INTRO	NOT ENTERED
SAT #1 REGULAR
SAT #2 REGULAR
SAT #1 JUMPERS
SAT #2 JUMPERS
SAT #1GAMBLERS
SAT #2 GAMBLERS
SUN #1 BARRELERS
SUN #2 BARRELERS
SUN #1 HOOPERS
SUN #2 HOOPERS
SUN #1 TUNNELERS
SUN #2 TUNNELERS

Dog (2) Call Name

NADAC Number-Dog (2)

Please type in the correct format eg. 00-00000

Breed-Dog (2)

Date of Birth-Dog (2)

If using the calendar, select Year-Month-Date

Height at Shoulder in Inches-Dog (2)

Jump Height-Dog (2)

Prior to exemptions, divisions or categories

Breed Height Exemption-Dog (2)

What Category are You Entering-Dog (2)

Dogs Division-Dog (2)

Would you like Ribbons or Dog Treats, should you Qualify or Place with this dog

Handlers Name

First NameLast Name

Handler Division

RUNS ENTERED FOR DOG (2)

Rows	ELITE	OPEN	NOVICE	INTRO	NOT ENTERED
SAT #1 REGULAR
SAT #2 REGULAR
SAT #1 JUMPERS
SAT #2 JUMPERS
SAT #1GAMBLERS
SAT #2 GAMBLERS
SUN #1BARRELERS
SUN #2 BARRELERS
SUN #1 HOOPERS
SUN #2 HOOPERS
SUN #1 TUNNELERS
SUN #2 TUNNELERS

Dog (3) Call Name

NADAC Number-Dog (3)

Please type in the correct format eg. 00-00000

Breed-Dog (3)

Date of Birth-Dog (3)

If using the calendar, select Year-Month-Date

Height at Shoulder in Inches-Dog (3)

Jump Height-Dog (3)

Prior to exemptions, divisions or categories

Breed Height Exemption-Dog (3)

What Category are You Entering-Dog (3)

Dogs Division-Dog (3)

Would you like Ribbons or Dog Treats, should you Qualify or Place with this dog

Handlers Name

First NameLast Name

Handler Division

RUNS ENTERED FOR DOG (3)

Rows	ELITE	OPEN	NOVICE	INTRO	NOT ENTERED
SAT #1 REGULAR
SAT #2 REGULAR
SAT #1 JUMPERS
SAT #2 JUMPERS
SAT #1 GAMBLERS
SAT #2 GAMBLERS
SUN #1 BARRELERS
SUN #2 BARRELERS
SUN #1 HOOPERS
SUN #2 HOOPERS
SUN #1 TUNNELERS
SUN #2 TUNNELERS

Dog (4) Call Name

NADAC Number-Dog (4)

Please type in the correct format eg. 00-00000

Breed-Dog (4)

Date of Birth-Dog (4)

If using the calendar, select Year-Month-Date

Height at Shoulder in Inches-Dog (4)

Jump Height-Dog (4)

Prior to exemptions, divisions or categories

Breed Height Exemption-Dog (4)

What Category are You Entering-Dog (4)

Dogs Division-Dog (4)

Would you like Ribbons or Dog Treats, should you Qualify or Place with this dog

Handlers Name

First NameLast Name

Handler Division

RUNS ENTERED FOR DOG (4)

Rows	ELITE	OPEN	NOVICE	INTRO	NOT ENTERED
SAT #1 REGULAR
SAT #2 REGULAR
SAT #1 JUMPERS
SAT #2 JUMPERS
SAT #1 GAMBLERS
SAT #2 GAMBLERS
SUN #1 BARRELERS
SUN #2 BARRELERS
SUN #1 HOOPERS
SUN #2 HOOPERS
SUN #1 TUNNELERS
SUN # 2 TUNNELERS

Dog (5) Call Name

NADAC Number-Dog (5)

Please type in the correct format eg. 00-00000

Breed-Dog (5)

Date of Birth-Dog (5)

If using the calendar, select Year-Month-Date

Height at Shoulder in Inches-Dog (5)

Jump Height-Dog (5)

Prior to exemptions, divisions or categories

Breed Height Exemption-Dog (5)

What Category are You Entering-Dog (5)

Dogs Division-Dog (5)

Would you like Ribbons or Dog Treats, should you Qualify or Place with this dog

Handlers Name

First NameLast Name

Handler Division

RUNS ENTERED FOR DOG (5)

Rows	ELITE	OPEN	NOVICE	INTRO	NOT ENTERED
SAT #1 REGULAR
SAT #2 REGULAR
SAT # 1 JUMPERS
SAT #2 JUMPERS
SAT #1 GAMBLERS
SAT #2 GAMBLERS
SUN # 1 BARRELERS
SUN # 2 BARRELERS
SUN #1 HOOPERS
SUN #2 HOOPERS
SUN #1 TUNNERLERS
SUN #2 TUNNELERS

Dog (6) Call Name

NADAC Number-Dog (6)

Please type in the correct format eg. 00-00000

Breed-Dog (6)

Date of Birth-Dog (6)

If using the calendar, select Year-Month-Date

Height at Shoulder in Inches-Dog (6)

Jump Height-Dog (6)

Prior to exemptions, divisions or categories

Breed Height Exemption-Dog (6)

What Category are You Entering-Dog (6)

Dogs Division-Dog (6)

Would you like Ribbons or Dog Treats, should you Qualify or Place with this dog

Handlers Name

First NameLast Name

Handler Division

RUNS ENTERED FOR DOG (6)

Rows	ELITE	OPEN	NOVICE	INTRO	NOT ENTERED
SAT #1 REGULAR
SAT #2 REGULAR
SAT #1 JUMPERS
SAT #2 JUMPERS
SAT #1 GAMBLERS
SAT #2 GAMBLERS
SUN #1 BARRELERS
SUN # 2 BARRELERS
SUN # 1 HOOPERS
SUN # 2 HOOPERS
SUN # 1 TUNNELERS
SUN # 2 TUNNERLERS

This option is only available for handlers with multiple dogs at double run format trials; where multiple dogs are entered in the same level of a course. You must decide at the time of entry, as options cannot be changed after entry submission.

Please indicate which dog you prefer to run first if you have more than one dog entered into the same level and same class

We will try to accommodate your preference, but this may not always be possible due to jump heights.

Total No of Runs Entered for this Dog (1)

Total No of Runs Entered for this Dog (2)

Total No of Runs Entered for this Dog (3)

Total No of Runs Entered for this Dog (4)

Total No of Runs Entered for this Dog (5)

Total No of Runs Entered for this Dog (6)

Total No of Runs Entered for all Dogs

Total Fees to be Paid for all Dogs Entered

Entry Fee is $9.00 per run.

PAYMENT FOR THIS TRIAL CAN BE MADE VIA DIRECT BANK DEPOSIT

Account Name: Agility Dog Club of Victoria

BSB: 633 000

Account: 127479723

Reference: Please use your given name initial/s and surname

The person who signs this agreement represents that he/she is authorized to enter into this agreement on behalf of both exhibitor and the owner of the entered dog. In consideration of the acceptance of this entry:
1.1. As used here "NADAC" means the North American Dog Agility Council, LLC. And NADAC Australia, its members, officers, directors, employees, show chairs, show committees and agents.
1.2. Exhibitor/owner agree to abide by the rules and regulations of NADAC and any other rules and regulations appearing in the premium for this event.
1.3. Exhibitor/owner certify that the entered dog is not a hazard to persons, dogs or property and that the entered dog's rabies vaccination is current in accordance with the requirement of the state in which the dog resides.
1.4. Exhibitor/owner acknowledge all hazards presented by the event and the event premises, including, but not limited to, the condition of the surface, restrooms, security measures or lack of, electrical appliances, fittings, show rings, parking areas and the presence of unfamiliar animals and people; exhibitor and owner assume the risk of any harm arising from these.
1.5. Exhibitor/owner releases NADAC (including its respective officers, directors, employees, and members), Agility Dog Club of Victoria (including its officers, directors, members, and event organizing committee), Coimadai Park (including its officers, directors, members, and event organizing committee), Paws to Consider (including its officers, directors, members, and event organizing committee), and Moorabbin Airport (including its officers, agents, and employees) and the Local, State and Federal Governments of Australia and will defend them and hold them harmless from all present and future loss, injury, damage, claims, demands and liabilities involving the entered dog, the event or event premises. Without limiting the generality of the foregoing hold harmless provisions, exhibitor/owner hereby specifically assumes sole responsibility for and agrees to indemnify and save the aforementioned parties harmless from any and all loss and expenses (including legal fees) by reason of the liability imposed by law upon any of the aforementioned parties for damages because of bodily injuries, including death, at any time in consequence of my (our) participation in this event, howsoever such injury or death may be caused and whether or not the same may have been caused or may have been alleged to have been caused by negligence of the aforementioned parties or any of their employees or agents or any other persons

Please ensure you have submitted the required Risk Waiver and Health Declaration forms.

https://www.nadacaustralia.com/covid-19-health-declaration/

https://www.nadacaustralia.com/covid-19-risk-waiver/

Please Sign to Agree to the Terms as Listed Above

ADCV NADAC Trial Entry - 12th & 13th December 2020

Owners Details

Dog/s Entered

Dog (1) Details

Handlers Details - Dog (1)

Runs Entered - Dog (1)

Dog (2) Details

Handlers Details - Dog (2)

Runs Entered - Dog (2)

Dog (3) Details

Handlers Details - Dog (3)

Runs Entered - Dog (3)

Dog (4) Details

Handlers Details - Dog (4)

Runs Entered - Dog (4)

Dog (5) Details

Handlers Details - Dog (5)

Runs Entered - Dog (5)

Dog (6) Details

Handlers Details - Dog (6)

Runs Entered - Dog (6)

Handler options for multiple dogs at Double Run format trials.

Payment

PAYMENT FOR THIS TRIAL CAN BE MADE VIA DIRECT BANK DEPOSIT