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  1. BREED: ……………………………………………………………………..….…..……………….. EXHIBIT: …………………………………………………….…………………………………...….. DOB: …./ …./ …….. DOG/BITCH: Registered No: …….………….……….… Bred by: …………………………………………………………………………………………….. Sire: …………………………………………….................. Reg No: ………………………….. Dam: ……………………………………………................. Reg No: ………………………….. Registered Owner: ………………………………….......... VCA Membership No: Usual Signature: …………………………………………... …………………………………… Postal Address: ………………………………………………………………..….…..…………. Postcode: ............ Phone: …………………….. Mobile: …………………..….…..………... Email: ………………………………………………. HAS: …..…. mm Additional Info: ……………….……………………… PERFORMANCE ENTRY FORM (Event to be held under Rules & Regulation of Victorian Canine Association Inc.) ………………………………………… (Name of Affiliate Conducting Fixture) EXHIBIITORS DECLARATION I hereby apply to enter the foregoing Exhibit in terms of and upon the conditions set out in the Association Constitution Rules and Regulations by which I agree to be bound, and I hereby certify to the correctness of the particulars endorsed hereon. Cat No: ……………..… (Office Use) ____________________________________ AM / PM ___________________________ Date: …. / …. / …….. Obedience: ……………......... Tracking Test: …………...…. Known TrackLayer: ……….. Earthdog Test: …….......…… Herding: ……………………... RAFT: ………………………… Endurance: ………………….. Entry Fees: ………………… Catalogue: .………………… Sundries: …...……………… TOTAL: $…….……………… Member of: …………………………... ………………………………....Club/s BREED: ……………………………………………………………………..….…..……………….. EXHIBIT: …………………………………………………….……………………...……………….. DOB: …./ …./ …….. DOG/BITCH: Registered No: …………….…….…….… Bred by: …………………………………………………………………………………………..…. Sire: …………………………………………….................. Reg No: ………….……………….. Dam: ……………………………………………................. Reg No: …………….…………….. Registered Owner: ………………………………….......... VCA Membership No: Usual Signature: …………………………………………... ……………………………………. Postal Address: ………………………………………………………………..………..…………. Postcode: ............ Phone: …………………….. Mobile: …………………..…...…..………... Email: ………………………………………………. HAS: …..…. mm Additional Info: ……………..……..………………… PERFORMANCE ENTRY FORM (Event to be held under Rules & Regulation of Victorian Canine Association Inc.) ………………………………………… (Name of Affiliate Conducting Fixture) EXHIBIITORS DECLARATION I hereby apply to enter the foregoing Exhibit in terms of and upon the conditions set out in the Association Constitution Rules and Regulations by which I agree to be bound, and I hereby certify to the correctness of the particulars endorsed hereon. Cat No: ……………..… (Office Use) ____________________________________ AM / PM ___________________________ Date: …. / …. / …….. Obedience: ……………......... Tracking Test: …………...…. Known TrackLayer: ……….. Earthdog Test: …….......…… Herding: ……………………... RAFT: ………………………… Endurance: ………………….. Entry Fees: ………………… Catalogue: .………………… Sundries: …...……………… TOTAL: $…….……………… Member of: …………………………... ………………………………....Club/s

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