SPEEDWAY TRIAL PREMIUM LIST

SANCTIONED BY CANINE PERFORMANCE EVENTS, INC.

CPE ENTRY FORM AND DISCLAIMER

Official CPE Entry Form –

Imperial Polk Obedience Club of Lakeland, Florida

Trial Dates: May 30 & 31, 2026 Final Closing Date: May 20, 2026

Entry Method: First received without an opening date Make entry fees payable in US funds to: IPOC

Mail Entries to: Lori Harman-Potteiger, 2011 Christy Lane, Lakeland, FL 33801-9305

DISCLAIMER AND INDEMNITY TO BE INCLUDED WITH ENTRY I/we acknowledge that I am/we are familiar with the current rules applying to CPE Trials, including all terms and conditions contained in this Event Premium, and agree to abide by all rules and T&C. I/we agree that the Host Club holding this trial has the right to refuse entry for cause which the Host Club, in its sole judgment, must deem to be sufficient. Upon acceptance of this entry, I/we agree to hold (a) Canine Performance Events, Inc., (b) this Host Club, (c) the owner or lessee of the premises, (d) any sponsors of this event, and each of their members, directors, officers, agents, Trial Secretary, Trial Chairperson, Trial Committee and employees harmless from any claim or loss or injury or expenses (including attorney fees) which may be alleged to have been caused directly or indirectly to any person or thing arising out of or in consequence of my/our participation in the SpeedWay trial or the act of my/our dog, howsoever such injuries or damage may be caused and whether or not the same may have been caused by negligence of the aforementioned parties or any of their employees or agents, or any other persons. I/we further agree to hold the aforementioned parties harmless from any claim or loss of this dog by disappearance, theft, death or otherwise, and from any claim for damage or injury to the dog, whether any claim be caused or alleged to be caused by the negligence of the Host Club or any of the parties aforementioned, or by the negligence of any other person, or any other cause or causes.

THIS DISCLAIMER MUST BE SIGNED AND INCLUDED FOR A VALID ENTRY

 I/we testify that the dog entered is healthy and vaccinated or titered. I/we certify that the dog entered is not dangerous to any person or other dog. By signing below, I/we agree to the disclaimer and indemnity obligations on this entry form; including the statement below the signature line.

Changes to trial results will not be made once the trial has been completed. Handlers are responsible for the accuracy of information in their confirmation from the Trial Secretary (i.e., dog’s information), prior to running in a trial, and for reporting any discrepancies of posted results prior to leaving the trial site each day. Includes if there was a correction to a scribe sheet then the handler must verify that the results were corrected as well. Labels are not official results.

Package Price (if applicable): Pricing is only available for Pre-entry

• All 9 runs by one dog, per day for $96 or

• All 18 runs by one dog on both days $180

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CPE SPEEDWAY ENTRY FORM – DOG/HANDLER INFO: MUST BE INCLUDED WITH THE DISCLAIMER

When team classes are offered: If a Partner is not listed on the form, the club will randomly pair up the teams. If there is an odd number of dogs entered in that class, a dog may be asked to run for no score as a fill in for the odd numbered dog, which is referred to as an accommodating dog.

SATURDAY 5/30 Available Class Runs - NO Rd 4 Runs

SUNDAY 5/31 Available Class Runs - NO Rd 4 Runs

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CPE SPEEDWAY ENTRY FORM – DOG/HANDLER INFO:

MUST BE INCLUDED WITH THE DISCLAIMER

When team classes are offered: If a Partner is not listed on the form, the club will randomly pair up the teams. If there is an odd number of dogs entered in that class, a dog may be asked to run for no score as a fill in for the odd numbered dog, which is referred to as an accommodating dog.

SATURDAY 5/30 Available Class Runs - NO Rd 4 Runs

SUNDAY 5/31 Available Class Runs - NO Rd 4 Runs

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CPE SPEEDWAY ENTRY FORM – DOG/HANDLER INFO:

MUST BE INCLUDED WITH THE DISCLAIMER

When team classes are offered: If a Partner is not listed on the form, the club will randomly pair up the teams. If there is an odd number of dogs entered in that class, a dog may be asked to run for no score as a fill in for the odd numbered dog, which is referred to as an accommodating dog.

SATURDAY 5/30 Available Class Runs - NO Rd 4 Runs

SUNDAY 5/31 Available Class Runs - NO Rd 4 Runs

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