OFFICIAL UNITED KENNEL CLUB, INC. JUNIOR ENTRY FORM
HOST CLUB: Dodge County Canine Club
Date: December 13, 2024 Show 1 Show 2	Date: December 14, 2024 Show 1 Show 2	Date: December 15, 2024 Show 1 Show 2
Dog must not be entered without a permanent UKC® registration number or a UKC Temporary Listing number. If your dog's permanent registration is pending at UKC, and you do not have a valid TL number, your entry will be invalid.
Dog's UKC Permanent or TL #:
*Breed of Dog: Select One...Unrecognized BreedAffenpinscherAfghan HoundAidiAiredale TerrierAkbash DogAkitaAlaskan Klee KaiAlaskan MalamuteAlentejo MastiffAlpine DrachsbrackeAmerican Black & Tan CoonhoundAmerican BulldogAmerican BullyAmerican EskimoAmerican FoxhoundAmerican Hairless TerrierAmerican Leopard HoundAmerican Pit Bull TerrierAmerican Water SpanielAnatolian ShepherdAnglo-Francais de Petite VenerieAppenzellerAriegeoisAustralian Cattle DogAustralian KelpieAustralian ShepherdAustralian TerrierAustrian Black and Tan HoundAustrian PinscherAzawakhBarakBarbetBasenjiBasset Artesien NormandBasset Bleu De GascogneBasset Fauve De BretagneBasset HoundBavarian Mountain HoundBeagleBeagle HarrierBearded CollieBeauceronBedlington TerrierBelgian Shepherd DogBergamascoBerger Des PyreneesBerger PicardBernese Mountain DogBichon FriseBiewer TerrierBillyBlack Forest HoundBlack Mouth CurBlack Russian TerrierBloodhoundBluetick CoonhoundBologneseBorder CollieBorder TerrierBorzoiBoston TerrierBouvier Des ArdennesBouvier des FlandresBoxerBoykin SpanielBracco ItalianoBraque D'AuvergneBraque de BourbonnaisBraque de l'AriegeBraque Francais, de Grande TailleBraque Francais, de Petite TailleBraque Saint GermainBriardBriquet Griffon VendeenBrittanyBrussels GriffonBull TerrierBullmastiffCa de Bestiar (Majorca Shepherd Dog)Cairn TerrierCanaan DogCanadian Eskimo DogCane Corso ItalianoCao de Castro LaboreiroCardigan Welsh CorgiCarolina DogCatalan SheepdogCaucasian OvcharkaCavalier King Charles SpanielCentral Asian ShepherdCesky FousekCesky TerrierChart Polski (Polish Greyhound)Chesapeake Bay RetrieverChien d'ArtoisChien Francais Blanc et NoirChien Francais TricoloreChihuahuaChinese CrestedChinese Shar-PeiChinookChow ChowCimarron UruguayoCiobanesc Romanesc CarpatinCiobanesc Romanesc MioriticCirneco dell'EtnaClumber SpanielCocker SpanielCollieCoton De TulearCroatian SheepdogCurly-Coated RetrieverCzechoslovakian Vlcak (Czechoslovakian Wolfdog)DachshundDalmatianDandie Dinmont TerrierDanish-Swedish FarmdogDanish BroholmerDeutsche BrackeDeutscher Wachtelhund (German Spaniel)Doberman PinscherDogo ArgentinoDogue De BordeauxDrentse PatrijshondDreverDunkerDutch ShepherdDutch SmoushondEast Siberian LaikaEnglish BulldogEnglish Cocker SpanielEnglish CoonhoundEnglish FoxhoundEnglish PointerEnglish SetterEnglish ShepherdEnglish Springer SpanielEnglish Toy SpanielEntlebucherEpagneul Bleu de PicardieEpagneul BretonEpagneul PicardEpagneul Pont-AudemerEstrela Mountain DogEurasianField SpanielFinnish HoundFinnish LapphundFinnish SpitzFlat Coated RetrieverFrancais Blanc et OrangeFrench BulldogFrench SpanielFresian Water DogGerman Long Haired PointerGerman PinscherGerman Rough Haired PointerGerman Shepherd DogGerman Shorthaired PointerGerman SpitzGerman Wirehaired PointerGiant SchnauzerGlen of Imaal TerrierGolden RetrieverGordon SetterGrand Basset Griffon VendeenGrand Bleu De GascogneGrand Gascon-SaintongeoisGrand Griffon VendeenGreat Anglo-Francais Tricolor HoundGreat Anglo-Francais White and Black HoundGreat Anglo-Francais White and Orange HoundGreat DaneGreat PyreneesGreater Swiss Mountain DogGreenland DogGreyhoundGriffon Bleu de GascogneGriffon Fauve de BretagneGriffon NivernaisHaldenstover HamiltonstovareHanoverian HoundHarrierHavaneseHellenic HoundHokkaidoHovawartHungarian Greyhound Hungarian Wire-Haired VizslaHygen HoundIbizan HoundIcelandic SheepdogIrish Red and White SetterIrish SetterIrish TerrierIrish Water SpanielIrish WolfhoundIstrian Coarse-Haired HoundIstrian Short-Haired HoundItalian GreyhoundItalian HoundJack Russell TerrierJagdterrierJapanese AkitaJapanese ChinJapanese SpitzJapanese TerrierJindoKaiKangal Dog>Karelian Bear DogKarst Shepherd DogKeeshondKerry Blue TerrierKishuKomondorKooikerhondjeKromfohrlanderKuvaszLabrador RetrieverLagotto RomagnoloLakeland TerrierLancashire HeelerLapinporokoira (Lapponian Herder)LeonbergerLhasa ApsoLouisiana Catahoula Leopard DogLowchenLundehundMajorca MastiffMalteseManchester TerrierMaremma SheepdogMastiffMi-KiMiniature American ShepherdMiniature Bull TerrierMiniature PinscherMiniature SchnauzerMontenegrin Mountain HoundMountain CurMountain FeistMudiMulti-Colored PoodleMulti-Colored Standard PoodleMunsterlander (Large)Munsterlander (Small)Neapolitan MastiffNewfoundlandNorfolk TerrierNorrbottenspetzNorwegian BuhundNorwegian ElkhoundNorwich TerrierNova Scotia Duck Tolling RetrieverOld Danish Pointing DogOld English SheepdogOlde English BulldoggeOtterhoundOwczarek PodhalanskiPapillonParson Russell TerrierPatterdale TerrierPekingesePembroke Welsh CorgiPerdiguero de BurgosPerro De Presa CanarioPeruvian Inca OrchidPetit Basset Griffon VendeenPetit Bleu De GascognePetit Gascon-SaintongeoisPharaoh HoundPlott HoundPodenco CanarioPodengo PortuguesoPoitevinPolish HoundPolski Owczarek NizinnyPomeranianPoodlePorcelainePortuguese PointerPortuguese SheepdogPortuguese Water DogPosavaz HoundPudelpointerPugPuliPumiPyrenean MastiffRat TerrierRedbone CoonhoundRhodesian RidgebackRottweilerRussian-European LaikaRusskiy ToySaarloosewolfdogSaint BernardSalukiSamoyedSarplaninacSchapendoesSchiller HoundSchipperkeScottish DeerhoundScottish TerrierSealyham TerrierSerbian HoundSerbian Tricolor HoundShetland SheepdogShibaShih TzuShikokuSiberian HuskySilken WindhoundSilky TerrierSkye TerrierSloughiSlovac CuvacSlovakian Wire-Haired Pointing DogSmaland HoundSmall Swiss HoundSmooth Fox TerrierSoft-Coated Wheaten TerrierSouth African BoerboelSouth Russian Shepherd DogSpanish GreyhoundSpanish HoundSpanish MastiffSpanish Water DogSpinone ItalianoSporting Lucas TerrierStabyhounStaffordshire Bull TerrierStandard PoodleStandard SchnauzerStephens' CurStumpy Tail Cattle DogStyrian Coarse Haired HoundSussex SpanielSwedish ElkhoundSwedish LapphundSwedish VallhundSwiss HoundTeddy Roosevelt TerrierThai RidgebackTibetan MastiffTibetan SpanielTibetan TerrierTornjakTosa KenToy Fox TerrierTransylvanian HoundTreeing CurTreeing FeistTreeing Walker CoonhoundTyrolean HoundVizslaVolpino ItalianoWeimaranerWelsh HoundWelsh Springer SpanielWelsh TerrierWest Highland White TerrierWest Siberian LaikaWestphalian DachsbrackeWhippetWhite ShepherdWire Fox TerrierWirehaired Pointing GriffonXoloitzcuintliYorkshire Terrier       Variety (if applicable): N/A       *Dog's Height at Withers:        *Sex: Select One...MaleFemale
*Dog's Name:
*Call Name:    *Date of Birth:
*Junior Name:    *Junior #:
*Dog owner's name(s):
*Address:
*City:     *State: AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY   *ZIP:
*Phone:    *E-mail:
Junior Showmanship Class: Pee Wee (2 years - under 4 years) Sub JR (4 years - under 6 years) Pre-Junior (6 years - under 8 years) Novice Junior (8 years - under 13 years) Open Junior (8 years - under 13 years) Novice Senior (13 years - 18 years) Open Senior (13 years - 18 years)
Rally Class(es): RO1 A RO1 B RO1 C RO2 A RO2 B RO3 A RO3 B ROM A ROM B		Jump Height: Minimum Height Standard Height
WAIVER All events are held under the Official Rules and Regulations of the United Kennel Club. Absolutely no alcoholic beverages, illegal drugs or firearms will be allowed on the grounds or in the buildings on the day of a UKC Licensed event. UKC, its agents and employees, and the host club assume no responsibility for any loss, damage, or injury sustained by spectators or by exhibitors and handlers, or to any of their dogs or property, and further assume no responsibility for injury to children not under the control of their parents or guardians. UKC and the host club are not responsible for loss, accidents or theft. By signing this form, I hereby agree to waive any claim, action, or lawsuit and further agree to indemnify and hold UKC, the host club and any approved UKC Judge harmless from any claims, actions or lawsuits resulting from my participation in this event, and any action, decision or judgment made by any UKC or host club representative or approved Judge under the official UKC Rules and Regulations governing this event. I acknowledge that the current Official UKC Rules and Regulations (Agility, Conformation, Dock Jumping, Drag Race, Juniors, Lure Coursing, Obedience, Rally Obedience, Weight Pull, Precision Coursing) have been made available to me, and that I am familiar with their contents. My signature indicates that I understand and agree to the above and to abide by all of the current Official UKC Rules and Regulations.  I Agree I have read and agree to the waiver on this electronic entry form. By pressing the submit button I understand that doing so is in lieu of an actual signature, and that the information entered above is correct to the extent of my knowledge. After pressing submit, you will be given the opportunity to make a payment.