The document is a registration form for a dog trial event hosted by Tarheel Canine on April 9-10, 2016. It lists the different levels and prices for events on both Saturday and Sunday. There is a $5 discount per event if registered by April 1. Participants must be a member of PSA and bring their scorebook. The form requests name, address, phone, dog information, and signature releasing the organizers from liability. Payment can be made by check or money order mailed in or cash on the day of the event.

1. 919.244.8044
April 9 & 10, 2016
Please check any events you wish to enter for the weekend. Note: $5.00 off each entry received by
April 1, 2016. To pre-register, please send the completed registration form and payment (check or
money order) to: Tarheel Canine, 230 W Seawell Street, Sanford, NC 27330. Make checks/money
orders payable to Tarheel Canine. All entries paid the day of the trial MUST BE PAID IN CASH. NO
EXCEPTIONS.
Saturday Sunday
PDC $55.00 PDC $55.00
PDC-SD $55.00 PDC-SD $55.00
Level 1 $55.00 Level 1 $55.00
Level 2 $65.00 Level 2 $65.00
Level 3 $65.00 Level 3 $65.00
Note: You must be a member of PSA to show in the trial. You may join PSA the day of the trial. PLEASE BRING
YOUR SCOREBOOK ON THE DAY OF THE TRIAL AND PRESENT IT AT REGISTRATION. If you need a scorebook,
you may purchase one at registration on Saturday.
**Please put a check mark next to all events for which you would like to be registered.
Name: Membership #
Address:
City: State: Zip:
Phone: E-mail:
Club Name: Dog’s Name:
Titles: Age:
Owner Trained: Yes No:
Amount Enclosed for events:
(Note: Deduct $5 per event if your registration arrives in our office by April 1, 2016)

2. RELEASE: It is the understanding that the above handler / dog team are entering this trial AT THEIR OWN RISK. I understand
that serious accidents can and do occur during dog training, competitions and other dog related events / activities. I am assuming
all risk, liabilities and responsibilities and will hold harmless PSA K9, Tarheel Canine Training, Inc., Lee County High School,
their agents, partners, employees, sponsors from ANY AND ALL liability arising from this dog-related event and practice training
while at Lee County High School. I also agree to hold harmless any of the above mentioned from any property damage, theft,
death or personal injury to my dog or myself. I also agree to have complete control over myself and my dog(s) at all times. By
signing this entry form I acknowledge that I have read and understood the trial waiver and read and understand all PSA rules
that govern trials. There will be no refunds given to any handler that has been ejected from this trial for any reason. In addition,
by signing this release I give consent to any representative of PSA or Tarheel Canine Training, Inc, to take pictures of events
and any activities surrounding the events, said pictures shall be the sole and exclusive property of Britney Bradshaw for their
sole and exclusive use and distribution. Further by signing this, I release any rights to the sale, posting or distribution of any
pictures taken by Stefanie Suddeth and waive any right to remuneration or compensation for any picture taken or sold of the
events in question.
SIGNATURE: Date: