USDAA Entry Form

USDAA® Online Entry Form

Mid-Atlantic MADness

March 28 - March 29, 2015

Closing Date March 14, 2015

Note: This is a beta test only !
Dog's Call Name*
USDAA #*
Breed*
Height*
Birthdate*

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Day Phone

Area CodePhone Number
Night Phone*

Area CodePhone Number
Handler*

First NameLast Name
Email*
Championship Jump Height
Performance Jump Height
Veterans Jump Height
Saturday Standard
$14.00
Saturday Gamblers
$14.00
Saturday Jumpers
$14.00
Saturday Masters Challenge
$14.00
Saturday Pairs
$14.00
Partner Information - This is a template you can edit as needed
Partner:Dog: USDAA#: Jump Height: -or- Partners to exclude from draw:If blank or incorrect, entry will be for draw team
IFCS Contribution
$1.00 or more
Camping Fee
Discount
Handy Calculator (Note: use the '=' pushbutton. The enter key clears the calculator). iOS Users: this tool may not appear for you)
Total Fees*
Note to Trial Secretary
Name of Parent or Legal Guardian, if entry is for a Minor
Signature*
Typing your name here and checking the box below constitutes an electronic signature
General Agreement & Acceptance*

I have electronically signed this entry form and by doing so, I declare that I have read USDAA Official Rules & Regulations and the General Agreement and Test Schedule provisions set forth for entry to this event, and I acknowledge that I understand and agree to abide by all such rules, regulations, policies and provisions stipulated therein, including any provisions incorporated by reference.
Placeholder for Paypal button
Go ahead and submit it. There's no charge (no Paypal button has been created for this form yet!) & it helps me test out the form :)
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