Trial Entry submission Trial Entry Trial Entry form Step 1 of 3 33% Personal informationName* First Last Email* TelephoneMobile PhoneAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code VYUFDA Membership Number*eg NSW19-152 or 19-152 Are you are a Junior ? Tick if you are a Junior Authorisation by Parent / GuardianTo be completed by Parent / Guardian* As this Junior's parent/guardian I authorise them to enter this trial. Parent / Guardian Name* First Last Parent / Guardian NameParent / Guardian phone number* AgreementsEntry Agreement* I enter entirely at my own risk and undertake not to make a claim against the VYUFDA members or Yea A, P & H Assoc, for any damage or injury arising at, out of, or in connection with this trial. I accept full responsibility for any damage or injury caused to a member of the public by myself or my dog/s. Consent to photos or videos being published* I give permission to the trial convener and VYUFDA, to publish photos or videos taken during the trial on the convener's and Association's website and Facebook accounts. EntriesEnter Dog's Name including Prefix*Dog's NameSectionAmount OpenImproverNoviceEncourageMaiden Details of Dogs being entered - If dogs are balloted out because of too many entries, the first dog entered will be balloted out until entry numbers are not oversubscribed.EmailThis field is for validation purposes and should be left unchanged.