Owner's Name: ______________________________________________________________________

Address: ___________________________________________________________________________

City: ________________Prov./State: ___________ Zip: _______ Phone __________________________

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

For official use: Received: Date & Initial ______________________

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