Owner's Name: _________________________________________________ Phone: ________________

Address: ____________________________________________________________________________

City: ________________ Prov./State: ___________ Zip: _____________

Location of Event: _________________________________________________ Date: ______________

Event Managing Organization/Club:_______________________________________________________

Secretary's Name and Address:___________________________________________________________

__________________________________________________________________________________

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

Dog's Weight at Event: ________________________________ Weight Class: _____________________

Maximum Completed Pull (16 feet in allotted time) _____________________________________________

Vehicle Used: Sled ___________ Wheeled Rig __________ Other (please specify) __________

Type of Surface of Pulling Area ___________________________________________________________

Temperature: _______________ Conditions _________________________________________________

Were events run under ISDRA _____ IWPA _____ Rules? (Check one)

To be completed by Event Official:

I hereby certify that the above-named dog was entered in and did complete all events as listed on this form.

Name (please print) ______________________________ Signature ____________________________

Date: _________________________ Title: Marshall _____ Judge _____ Timer _____ Other _____

Address __________________________________________________________ City_____________

Prov./State____________ Zip ______________ Phone ______________________________________

All necessary forms must be sent with application fee of $10.00 for the first dog and $5.00 for subsequent 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

For official use: Received: Date & Initial ______________________

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