The 14th Annual Rip
Van Wrinkle Basenji Club Specialty Match, July 11th, 2010
JUDGE: Sharon Beuhler ~ Held at the Stockade Polo &
Saddle Club, Glenville, NY
PLEASE PRE-ENTER! - Early
Entries close Saturday, July 5th (Day of show entries will CLOSE AT 10 am - fees will
go up to $12 first entry, $4 addÕl entry of same dog.)
Dog's Name:
_________________________________________Sex _________
Date of
Birth:__________________________ Other than basenji?______________
o
Musical Sits,
o Musical Downs,
o
Best Yodeler
o
Best Wrinkles
o
Curliest Tail,
o 12th Annual Bambi Memorial
Veggie Eating Contest,
o Costume Class (My Favorite
AVATAR)
o
Parade of Veterans
o
Parade of Rescues
o
Parade of Title
Holders
Pre-Entry Fees:
$6 for first entry, $2 for each addÕl entry of same dog, Parades always
free.
Raffle
for Basenji Health Endowment ~Tickets: 6 for $10.
1.
Original pencil drawing, (Puppies in Basket) by Susan Kamen Marsicano
TOTAL: $_____.___ make checks to the Rip Van Wrinkle Basenji
club & mail to:
Susan
Marsicano, 12 Muse
Road, Woodstock, NY 12498-2509
Owner's
Name:___________________________________________Email____________
Address_________________________________________________Phone____________
I
(we) waive any and all claims, causes of action, I (we) might otherwise have against
the RVW club, and any approved judge, judging at this show. I (we) agree to
hold this club, its members,
directors, governors, officers, agents, superintendents or show secretary and
the owner or lessor of the premises and any employees of the aforementioned
parties harmless from any claim
for loss or injury which may be alleged to have been caused directly or
indirectly to any person or thing by the act of this dog while in or upon the
show, obedience or agility trial
premises or grounds or near any entrance thereto; and I (we) personally assume
all responsibility and liability for any such claim; and I (we) further agree
to hold the aforementioned parties harmless from any claim for loss of this dog
by disappearance, theft, death or otherwise, and from any claim for damage or
injury to the dog, whether such loss, disappearance, theft, damage, or injury
be caused or alleged to be caused by the negligence of the club or any of the
parties aforementioned, or by the negligence of any other person, or any other
cause or causes.
I
(we) hereby assume the sole responsibility for and agree 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 damage because of bodily injuries, including
death at any time resulting therefrom, sustained by any person including myself
(ourselves) on or account of damage to property, arising out of or in
consequence of my (our) participation in this show, howsoever such injuries,
death or damage to property 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.
I CERTIFY that I
am the actual owner of the dog, and agree to be bound by Òthe AgreementÓ
printed above. I (We) certify and represent that the dog entered is not a
hazard to persons or other dogs. This entry is submitted for acceptance on the
foregoing representation and agreement.
á Signed
_________________________________________ Date________________