TEMPERAMENT TEST ASSOCIATES

P.O. Box 149,                                                                                                                                             Sandie Bingley   905-894-4945  
St. Davids, Ontario                                                                                                                                     sandon@sandonkennels.com  
LOS 1PO                                                                                                                                                    Olga Gagne   905-262-4682  
                                                                                                                                                                    bluechip149@sympatico.ca

ENTRY FORM                                                                                                                                 OFFICIAL USE

Host Club  GREATER MID-ONTARIO DOBERMAN FANCIERS               Dog #__________________________
Date   SEPTEMBER 13, 2008                                                                               TT # ___________________________

Entry Fee  $35 before September 4 / $40 after September 4     Cash______Cheque_______  
Make cheques payable to Greater Mid-Ontario Doberman Fanciers
NO REFUNDS

PLEASE PRINT ONE FORM FOR EACH DOG ENTERED                                                                                ONE YEAR MINIMUM 

BREED___________________________________ MALE__________  FEMALE__________  AGE_____________  
                                                                                               NEUTERED____________SPAYED______________  
Check all that apply.  

House dog _______ Conformation _____ Tracking _________ Herding _________
Kennel dog ______ Obedience ________ Field work ________ Therapy _________
Both ___________ Protection ________ Agility ___________ Other ___________

Comments_________________________________________________________________________________________  
Name of Dog_______________________________________________________________________________________  
Reg.#______________________Birth Date__________________________Breeder_______________________________
Sire______________________________________________________________________________________________
Dam______________________________________________________________________________________________ 
Owner_______________________________________________Handler_______________________________________
How long have you owned this dog?_____________________________________________________________________ 
Address______________________________________City__________________________________________________  
Phone # (________)_____________________________Postal Code____________________________________________  

I certify that I am the actual owner of this dog or that I am the duly authorized agent of the actual owner whose name I have entered on this form in consideration of the acceptance of this entry.  I/we agree to abide by the rules and regulations of this Organization, and I/we further agree that the TTA officials conducting this evaluation have the right to refuse this entry for cause which TTA shall deem sufficient.  In consideration of this entry, I/we agree to hold the Temperament Test Associates, its officials and all participating officers, directors, members, advisor, etc., agents and any employees of the aforementioned parties harmless from any and all claims for loss or injury which may be alleged to have been caused directly or indirectly to any person, property or thing by the act of this dog or any other dog(s) belonging to me, or which I have brought with me, and/or test participant while in or upon the test premises or ground or near any entrance thereto, and I/we shall personally assume all responsibility and liability for any such claim, and I/we further agree to hold the aforementioned parties harmless for any claims or loss of or injury to this dog by disappearance, theft, damage or injury, etc. be caused or alleged by the negligence of TTA or any of the aforementioned parties or by the negligence of any other person or any other cause or causes.  I/we certify and represent that this dog entered is not a hazard to persons or other dogs.  This entrance is submitted for acceptance on the foregoing representation and agreement.  I/we also agree to forever release, acquit, discharge and covenant to hold harmless the TTA its officers, directors, members officials, advisors, successors and assigns of and all actions, causes of actions, claims, demands, cost, loss of services, expenses and compensation, on account of, or in any way growing out of the establishment and/or activities of TTA et al, and/or out of publication or dissemination the results of an evaluation of my/our dog during the activities of this evaluation.  I/we declare that my/our dog participating this day and as described on this application is free from all drugs, tranquillizers, barbiturates, etc. and that all information provided is correct.  I declare that I understand fully the above.  I consent to be bound by this agreement.  With my signature I/we agree to accept the decisions of the Temperament Test Associates at this test.  
                                                                                                                       SIGNATURE___________________________________________

Mail to:
Maura Reilly
383133 Edge's Sideroad
Durham, Ontario N0G 1R0