Registration ATIBOX WM FCI-IGP and FCI-IFH

Name of Handler*

First name Last name

Adress*

Street and home number City Postal code Country

License plate number Handler

Please enter the license platenumber of the car so we can make a parking card for all doghandlers in FCI-IGP

Class to participate*

Member of club*

Name of club

Membership number*

Mobile phone number Handler (incl. country code)*

E-mail Handler*

Name Team Captain (if applicable)

First name Last name

Phone number Team Captain (incl. country code)

E-mail Team Captain

Owner info same as Handler info*

Name of owner

first name last name

Country of owner

Member of club (name of club)

Member number

Mobile of owner (incl. country code)

E-mail of owner

Full pedigree name of the Dog*

Date of birth*

DD

MM

JJJJ

Pedigree registration number*

Chip number*

Sex*

Mother of your dog*

Father of your dog*

Highest passed exam BH/IGP/IFH + date of exam*

Number of tickets (€ 35 pp) Saturdayevening dinnerbuffet*

Photo of handler with the dog*

Please upload Photo of handler with the dog

Music title for entering on protection work

Handler can choose own music for when they enter arena in part C protection. Please enter title and artist so we can find it on spotify. When no music is chosen, organisation will choose for handler..

I agree to the terms and conditions of participation set out in the regulations of competition of the FCI, Atibox and the local organizer. Dutch law applicable. I agree with the record keeping of the above personal information. I confirm my participation in this competition by sending this Entry-form and paying entry fee. Signing is not necessary.*

Agree

Registration ATIBOX WM FCI-IGP and FCI-IFH

registration ATIBOX WM FCI-IGP & FCI-SPh