Owner's Name: _________________________________________________ Phone: ________________

Address: ____________________________________________________________________________

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

Location of Event: _________________________________________________ Date: ______________

Event Managing Organization/Club:_______________________________________________________

Secretary's Name and Address:___________________________________________________________

__________________________________________________________________________________

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 __________________________________

Were events run under ISDRA Rules? _____________________ AMHL Rules?___________________

I/We apply for certification for the following dogs: (List of dogs may be continued on back of form)
 

Dog's Name (Registered name if applicable)	Position	Lead/Team Certification
______________________________________  ______________________________________ ______________________________________ ______________________________________	________________  ________________ ________________ ________________	________________  ________________ ________________ ________________

Racing

Race Class: _______________________________________Number of Dogs on Team: ______________
 

Heat/Day	Distance	Your Time	Winning Time	Your Finish Position	Number of Teams Starting/Finishing
______	______	_______	__________	________	____________
______	______	_______	__________	________	____________
______	______	_______	__________	________	____________
______	______	_______	__________	________	____________

Weight Carried for Freight Race Excluding Sled and Driver :_______________________

General Trail Conditions: Weather, Snow Conditions, Topography, etc. ________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

Excursion
(name and address of an impartial witness must be listed above)

Location and Time of Start of Trip: __________________________________________________________

Location and Time of Finish of Trip: _________________________________________________________

Trip Description including Daily Mileage, Number of Overnights, Terrain, Hazards Encountered on the Trail, General Trail

Conditions, and Number of Dogs on the Team: _________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

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 ______________________