Trial Entry Form

1) Complete all fields
2) Click Submit
3) Make Payment by choosing the appropriate option below the trial entry form and submitting payment. Registration is not complete until payment is made.

Download September 28-29th Trial Entry Form and Trial Flyer here:

September 28th, 2019 Trial Entry Form
September 28th, 2019 Trial Flyer

Handler & Dog Information
Handler's Name*
First Last
Email*
Phone*
Address*
Street Address City State / Province / Region ZIP / Postal Code
Club Affiliation*
Previous Titles and Date of BH*
Dog's Registered Name*
Dog's Gender*
Dog's DOB*
Scorebook Number*
Organization Affiliation & Member Number
Breed*
Registration Number*
Tatoo or Microchip Number*
Trials & Payment Information
BH-Vt
Price: $70.00 Quantity:
IGP-V
Price: $75.00 Quantity:
IGP Title - IGP 1
Price: $75.00 Quantity:
IGP Title - IGP 2
Price: $75.00 Quantity:
IGP Title - IGP 3
Price: $75.00 Quantity:
IFH Title - IFH-V
Price: $75.00 Quantity:
IFH Title - IFH-1
Price: $75.00 Quantity:
IFH Title - IFH-2
Price: $75.00 Quantity:
IGP-FH
Price: $100.00 Quantity:
F. Pr. 1-3
Price: $75.00 Quantity:
U. Pr. 1-3
Price: $75.00 Quantity:
G. Pr. 1-3
Price: $75.00 Quantity:
RH
Price: $75.00 Quantity:
NOTE: there is a $20 late fee that must be paid separately if those fees apply.
Add Late Fee
Price: $20.00 Quantity:
Total
$0.00
Once you submit this donation form, please complete your payment via the Liberty Working Dog Club PayPal account on the next page.
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Trial Entry Form

Handler & Dog Information

Trials & Payment Information