Agility Class:          --none-- 8 inch Agility 12 inch Agility 16 inch Agility 20 inch Agility 24 inch Agility

Obedience Class:   --none-- Novice Obedience Open Obedience Utility Obedience Super Star Obedience

Rally Class:            --none-- Novice Rally Advanced Rally Excellent Rally Super Rally

Dog Information:

Breed
Variety	(if applicable)
Sex	Male Female
Registered Name
Call Name
Date of Birth	(MM/DD/YYYY)
Height at Withers	inches
Obedience Jump Height	inches
Rally Jump Height	inches
Breeder
Sire
Dam
Registration Number
Registry

Owner/Handler information:

First Name
Last Name
Street Address
City
State/Province	(Use two letter abbreviation.)
Zip/Postal Code
Country (if not U.S.A.)
Home Phone
E-mail
Co-Owners
Handler (if other than owner)

Agility Qualifying Information:

Provide detailed information on one eligible qualifying score only if your dog does not have one of the qualifying titles. 

          Qualifying Title: --none-- AX or AXJ MX or MXJ MACH AXP or AJP MXP or MXJ PAX

Registry
Class/Division
Show
Location
Judge
Score
Date	(MM/DD/YYYY)

Obedience Qualifying Information:

Provide detailed information on one score of 193 or better or three scores averaging 190 or better.  For the Utility class, dogs with a UDX are exempt from the score requirement.  For the Super Star class, dogs with an OTCH, UOCH, or MOTCH are exempt from the score requirement.  Dogs entering Super Star without one of these titles must provide scores for both Open and Utility.

          Qualifying Title: --none-- CD CDX UD UDX OTCH, UOCH or MOTCH

Score	Class	Date	Show	Location	Judge

Rally Qualifying Information:

Provide detailed information on three scores averaging 95/190 or better.  For the Super Rally class, dogs with an RAE are exempt from the score requirement.  Dogs entering Super Rally without an RAE must provide scores for both Advanced and Excellent.

          Qualifying Title: --none-- RN or Level 1 RA or Level 2 RE or Level 3 RAE

Score	Class	Date	Show	Location	Judge

Please check the box below:

   I have read the rules contained in the premium list and agree to abide by them. I understand that attendance at this competition is not without risk to myself, members of my family or guests who may attend, or my dog. I hereby indemnify and hold All Star Performance Dog Association and its members or agents harmless of and from any and all claims, demands, suits, judgments, costs, attorneys' fees, and other damages arising out of occurrences in or at the site of the competition or surrounding areas.

Payment Method:

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