Owner's Name: _________________________________________________ Phone: ________________

Address: ___________________________________________________________________________

City: ________________Prov./State: ___________ Zip: _____________

Dog's Name: (Registered name if applicable):_________________________________________________

Location of Event: _________________________________________________ Date: ______________

Name of club/group sponsoring event:: ____________________________________________________

Participating Witness's Name: ___________________________________________________________

Participating Witness's Office/Title, Etc. ____________________________________________________

Address ____________________________________________________________________________

City_____________ Prov./State__________ Zip ______ Phone _________________________________

Dog's Weight: ______________ Weight Carried in Pack: ___________

START: Date: _______________ Time: ______________ Location: ______________________________

Witness Signature Out: _________________________________________________________________

Destination: _________________________________ Mileage to Destination: ______________________

FINISH: Date: _______________ Time: ______________ Location: ______________________________

Witness Signature In: __________________________________________________________________

Address & Phone and Office/Title if different from above: _______________________________________

___________________________________________________________________________________

Total Mileage Covered: _______________ Summary of Trail Conditions, Terrain, Weather, Etc. _________

___________________________________________________________________________________

Contents of Dog's Pack: ________________________________________________________________

Note: Form must be fully completed or it will not be processed.

Send application with fee of $10.00 for the first dog and $5.00 for other applications submitted at the same time to:

AMHL/Canuel
P. O. Box 59017
Canada Post, Pringle Creek
728 Anderson St.
Whitby, Ontario L1N 2E0

Please make cheques payable to the Alaskan Malamute HELP League

Number of qualifying "legs" completed/submitted to date, including this form:___________