September 13-14 Entry Form – LEGS Coursing Club

Select Date(s) for Registration *September 13September 14September 13 and September 14(select the date or dates then go to Add Entries to Cart then My Cart to pay)

Breed:

Call Name:

Registered Name of Hound:

Stake:

Additional Stakes:

Registration Number:(please write in registering body before number)

If possible, please separate my hounds.Yes

Date of Birth:

Sex:DogBitch

Name of actual owner(s):

Street Address:

Phone:

City:

State/Province:

ZIP / Postal Code:

Email Address:

Emergency contact name and phone:

Check if this is the first ASFA trial for this hound:Yes(attach a Hound Certification or waiver if entered in Open, Veterans, Provisional)

Check if this is a first-time entry:Yes(copy of the official Registration of this hound must accompany this entry unless NGA)

Check if any information has changed since the last ASFA trial entry, regarding:Yes(please enter changed information below)

Changed information:

Check if this hound has been dismissed within the last 6 trials entered.Yes(must be marked in order to qualify for a “clean” trial requirement)

Signature