Conformation Class Entry Form
Only recognized titles will be printed in the catalog for the dog entered, the dog’s sire and dam. Proof of titles must
be sent with this entry form. If proof of titles are not submitted, the dog will be entered into the open class. This form
may be duplicated however, only one dog may be entered per form. If the same dog is entered into more than one
class, you must send each entry for that dog on a separate entry form.
Please circle the class you are entering:
4-6 month 6-9 month 9-12 month (puppy classes $30.00)
12-18 month 18-24 month (youth classes $35.00)
Open Working Bred by Champion Veteran (adult classes $40.00)
CGC $15.00 ZtP $50.00
Please circle the sex of your dog.
Male Female
Dog’s Name ___________________________________________________________________________________
Titles: ________________________________________________________________________________________
DOB _________________Registration # ________________________Hip Cert.# ___________________________
Microchip/Tattoo # ________________________Country of Birth _______________________________________
Name of Sire: _________________________________________Registration # ____________________________
Titles held by Sire: _____________________________________________________________________________
Name of Dam : _______________________________________Registration # ____________________________
Titles held by Dam: ____________________________________________________________________________
Breeder(s): ___________________________________________________________________________________
Owner(s): ____________________________________________________________________________________
Address: ________________________________________________________Phone: _______________________
City: ___________________________State:________________________Zip Code: ________________________
Email Address: ___________________________________________Website: _____________________________
We agree to hold the Alliance of Independent Rottweiler Klubs, their members, officers and agents harmless from any loss or injury
may be alleged to have been caused by any person or thing while upon these show grounds. We agree to allow any infomation learned
about this Rottweiler to be published as well as all photographs taken at the show.
Signature Required: ____________________________Credit Card #___________________________Visa or Mastercard?
expiration date: ______________
Please mail to Sina Norris, East Carolina Rottweiler Klub, PO Box 1042, Hampstead, North Carolina 28443. All entries should be
received by February 28, 2007. For confirmation of entry, please email ECRK2004@yahoo.com.
We accept checks, money orders, Visa and Mastercard. Credit card payments please add $1.00 for processing. $25.00 will be
charged for any returned checks. Please make checks payable to East Carolina Rottweiler