KEEPSTONE FARM
BERRYVILLE, VA
KEEPSTONE FARM BERRYVILLE, VA |
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AHBA Entry and Waiver One form per dog; please fill out completely and legibly!
Registered Name _________________________________________________________
Name of Sire_______________________ Name of Dam__________________________
Registry & # ________________________________Sex _____ Birthdate____________
Owner _____________________________ Breeder _____________________________
Owner’s Address _________________________________________________________
Name of Handler if other than owner _________________________________________
Entry Fee Enclosed (see premium flyer) __$_____________________check #_______
Class: RLF_ Level: _____ Circle trials: Sat_____ Sunday_____ Stock: Sheep Class: RLF_ Level: _____ Circle trials: Sat_____ Sunday_____ Stock: Sheep Class: RLF_ Level: _____ Circle trials: Sat_____ Sunday_____ Stock: Sheep
WAIVER: Day(s) Attending (circle all that apply): Saturday Sunday
In consideration that I/we will be participating in an AHBA Trial to be held at Keepstone Farm (property owned by Susan Rhoades and Lisa Jett), I agree to hold blameless the aforementioned owners of Keepstone Farm, the participating AHBA judges, the Keepstone Farm staff, and members of the AHBA from liability in the event of harm to myself, my dog, family, and/or any spectators I have in my company while on the property before, during, and after the event. In addition, I/We will agree to pay for any damages to livestock or said property that is caused by me, my dog(s) and/or family/spectators I bring to the trial. I hereby agree to hold the aforementioned parties harmless and blameless and to defend them from any loss, claim, suit or damage that may occur as a result of this event. I/We agree to indemnify the AHBA, its officers, members, and directors from any loss, damage, claim, or expense, including attorneys fees and costs, which may in any way arise or result from the event. I/We have read the AHBA Herding Program Rules and Guidelines pertaining to this event and agree to abide by said Rules and Guidelines. I/We agree that control over the conduct of the event is solely mine/ours and not of the AHBA.
Signature: ____________________________________ Date: _____________________ |